主动脉球囊反搏器植入术治疗急性左心衰的应用价值

目的:探讨主动脉球囊反搏器植入术治疗急性左心衰的应用价值。方法:收集我院2013年2月-2016年1月收治的急性左心衰患者102例作为本次研究对象,根据随机信封抽签的方法将患者分为观察组和对照组,每组51例。对照组给予常规药物治疗,观察组在常规药物治疗的基础上加用主动脉球囊反搏器植入术,记录与观察两组患者的临床结局。结果:观察组的总有效率为96.1%,显著高于对照组的总有效率84.3%(P0.05)。治疗后,观察组与对照组的LVEF值分别为65.22±4.52%和58.20±5.31%,都明显高于治疗前的45.29±5.14%和45.20±4.89%,且观察组的LVEF值明显高于对照组(P0.05)。观察组治疗后随访6个月的死亡、顽固性缺血、恶性心律失常等近期主要终点事件发生率为5.9%,对照组为21.6%,观察组明显低于对照组(P0.05)。结论:主动脉球囊反搏器植入术治疗急性左心衰能促进左心室功能的改善,提高治疗效果,减少近期主要终点事件的发生。     

药物涂层球囊概述及其在外周动脉疾病治疗中的应用进展

经皮经腔血管成形术(PTA)已广泛用于外周动脉疾病(PAD)的治疗。然而,该技术存在血管壁弹性回缩和内膜增生等不足。PTA术后植入金属裸支架(BMS)虽然可以减少血管壁弹性回缩,但由此引起的支架内再狭窄(ISR)又成为治疗中的一个突出问题。药物洗脱支架(DES)被用来解决狭窄问题,但晚期支架内血栓形成(LST)、内皮化延迟和必须长期抗血小板治疗等问题也随之而来。在这样的背景下,药物涂层球囊(DCB)获得了快速发展。DCB作为非支架方案,可将所携载的活性药物转移至病变段血管壁,对ISR或原发病变均有较好的治疗效果。本文简要介绍了DCB的发展历史,并通过实验室研究、动物实验和临床试验,从机制上阐述涂层技术、涂层药物、赋形剂等对DCB功效和安全性的影响以及DCB在PAD治疗中的应用进展。     

Bacteriorhodopsin: a high-resolution structural view of vectorial proton transport

Recent 3-D structures of several intermediates in the photocycle of bacteriorhodopsin (bR) provide a detailed structural picture of this molecular proton pump in action. In this review, we describe the sequence of conformational changes of bR following the photoisomerization of its all-trans retinal chromophore, which is covalently bound via a protonated Schiff base to Lys216 in helix G, to a 13-cis configuration. The initial changes are localized near the protein's active site and a key water molecule is disordered. This water molecule serves as a keystone for the ground state of bR since, within the framework of the complex counter ion, it is important both for stabilizing the structure of the extracellular half of the protein, and for maintaining the high pK_a of the Schiff base (the primary proton donor) and the low pK_a of Asp85 (the primary proton acceptor). Subsequent structural rearrangements propagate out from the active site towards the extracellular half of the protein, with a local flex of helix C exaggerating an early movement of Asp85 towards the Schiff base, thereby facilitating proton transfer between these two groups. Other coupled rearrangements indicate the mechanism of proton release to the extracellular medium. On the cytoplasmic half of the protein, a local unwinding of helix G near the backbone of Lys216 provides sites for water molecules to order and define a pathway for the reprotonation of the Schiff base from Asp96 later in the photocycle. A steric clash of the photoisomerized retinal with Trp182 in helix F drives an outward tilt of the cytoplasmic half of this helix, opening the proton transport channel and enabling a proton to be taken up from the cytoplasm. Although bR is the first integral membrane protein to have its catalytic mechanism structurally characterized in detail, several key results were anticipated in advance of the structural model and the general framework for vectorial proton transport has, by and large, been preserved.     

Suppression of flash-induced PSII-dependent electrogenesis caused by proton pumping in chloroplasts

Pre-illumination of the thylakoid membrane of Peperomia metallica chloroplasts leads to a reversible suppression of the flash-induced electrical potential as measured either with the electrochromic bandshift (P515), microelectrode impalement or patch-clamp technique. The energization-dependent potential suppression was not observed in the presence of 1 μ M nigericin suggesting the involvement of proton and/or cation gradients. Energization in the presence of 3-(3,4-dichlorophenyl)-1,1-dimethylurea (DCMU) and N,N,N',N'-tetramethylphenylenediamine (TMPD), i.e. cyclic electron flow around photosystem (PS) I, results in the accumulation of TMPD⁺ in the thylakoid lumen. The reversible suppression of the flash-induced membrane potential was not observed in these conditions indicating that it is not a general cation-induced increase of membrane capacitance. Cyclic electron flow around PSI in the presence of DCMU and phenazine methosulfate (PMS) results in the accumulation of PMS⁺ and H⁺ in the thylakoid lumen. The absence of reversible suppression of the flash-induced membrane potential for this condition shows that accumulation of protons does not lead to (1) a reversible increase of membrane capacitance and (2) a reversible suppression of PSI-dependent electrogenesis. Reversible inactivation of PSII by a low pH in the thylakoid lumen is therefore proposed to be the cause for the temporary suppression of the flash-induced electrical potential. The flash-induced PSII-dependent membrane potential, as measured after major oxidation of P700 in far-red background light, was indeed found to be suppressed at low assay pH (pH 5) in isolated spinach ( Spinacia oleracea ) chloroplasts.     

四株盐杆菌中类紫质分子的探测

研究了四株盐杆菌Halobacterium sp. xiz 515.H.sp.dal s_2-1和H.sp.ausH_3a光驱动的质子泵功能及相应视黄醛蛋白的光化学反应.用pH电极测定了细胞悬浮液和胞外被膜(cellenvelope)介质中的光致△pH变化.实验发现,xiz.515和dals_2-1在照光时介质酸化.而另两株则相反,介质碱化.在这些盐杆菌中,进行了细胞膜各组份离心分离,其操作过程如同在Hhalobium上R中分离紫膜一样.最后得到的相应于紫膜组份的细胞膜中,没有发现表微菌紫质(BR)分子存在的吸收峰值.但是,在动力学光谱仪上却都发现此组份内具有与BR分子类似的光循环反应.本文假定,在这些盐杆菌中存在有微量的BR或类BR分子,它们以单体形式分散的小的聚集体散落在部份细胞膜上.     

Proton translocation in cytochromec oxidase: Redox linkage through proximal ligand exchange on cytochromea 3

An analysis of resonance Raman scattering data from CO-bound cytochromec oxidase and from the photodissociated enzyme indicates that histidine may not be coordinated to the iron atom of cytochromea ₃ in the CO-bound form of the enzyme. Instead, the data suggest that either a water molecule or a different amino acid residue occupies the proximal ligand position. From these data, it is postulated that ligand exchange on cytochromea ₃ can occur under physiological conditions. Studies of mutant hemoglobins have demonstrated that tyrosinate binds preferentially to histidine in the ferric forms of the proteins. In cytochromec oxidase tyrosine residues are located near the histidine residues recently implicated in coordination to cytochromea ₃ (Shapleighet al., 1992; Hosleret al., this volume). Expanding on these concepts, we propose a model for proton translocation at the O₂-binding site based on proximal ligand exchange between tyrosine and histidine on cytochromea ₃. The pumping steps take place at the level of the peroxy intermediate and at the level of the ferryl intermediate in the catalytic cycle and are thereby consistent with the recent results of Wilkstrom (1989) who found that proton pumping occurs only at these two steps. It is shown that the model may be readily extended to account for the pumping of two protons at each of the steps.     

Interaction between poly(L-lysine) and membranes inhibits proton pumping by corn root tonoplast H+-ATPase

The influence of poly(L-lysine) binding on the coupled activities of nitrate-sensitive H⁺-ATPase in isolated corn ( Zea mays L. cv. FRB73) root tonoplast vesicles was investigated. The addition of membrane-impermeable poly(L-lysine) caused a slow increase in light scattering of the tonoplast suspension. Electron microscopy showed that the increase was the result of an aggregation of the vesicles. In the presence of 75 m M KCl, a concentration sufficient to sustain near optimal ATP hydrolysis, poly(L-lysine) slightly enhanced the hydrolysis activity but significantly inhibited proton pumping of the H⁺-ATPase. Inhibition increased with the average molecular mass of poly(L-lysine) and reached a maximum at 58 kDa. When total osmolarity was kept constant, the replacement of sucrose by KCl enhanced both ATP hydrolysis and proton pumping activities. However, enhancement of proton pumping was significantly greater than that of ATP hydrolysis. An increase in KCl, but not K₂SO₄, significantly relieved poly(L-lysine)-induced inhibition of proton pumping. Kinetic analysis indicated that poly(L-lysine) did not significantly affect the proton leakage of the tonoplast membranes under different energetic conditions. These results suggest that the electrostatic interaction between poly(L-lysine) and the negative charges on the exterior surface of tonoplast vesicles could change the coupling ratio of ATP hydrolysis to proton pumping. Thus, the surface charge of the tonoplast membrane may be involved in the regulation of these two activities.     

Cytotoxicity acquired by ribosome-inactivating proteins carried by reconstituted Sendai virus envelopes

Association of the ribosome-inactivating proteins (RIPs): pokeweed antiviral protein (PAP), gelonin, Momordica charantia inhibitor (MCI), with reconstituted Sendai virus envelopes (RSVE) was obtained without detectable loss of activities either of RIPs or of viral envelope glycoproteins. RIPs are inactive towards intact cells, but, once encapsulated in RSVE, they become cytotoxic. The concentration of RSVE-associated PAP, which causes 50% inhibition of protein synthesis by Friend erythroleukemic cells, is 0.5 ng/ml. Substances capable to inhibit the viral activities block the acquired cytotoxicity of RIPs associated to RSVE.     

A subnanosecond resolving spectrofluorimeter for the analysis of protein fluorescence kinetics

A spectrofluorometer is described consisting of an excitation source, optics, detector and time resolving electronics. The excitation source consists of a mode-locked Ar ion laser, synchronously pumps a dye laser, followed by a frequency doubling device. The repetition frequency of the U.V. pulses (FWHM some ps) has been reduced by an extra-cavity electro-optical modulator. Provisions have been made in the optical configuration to determine both time-resolved fluorescence spectra and fluorescence anisotropy decay curves. The commercially avialable electronics have been optimized for maximum time resolution. The spectral output of the excitation source is confined between 280 and 310 nm, which encompasses the region for eliciting protein fluorescence. The performance of the complete system has been tested with single lifetime standards line p-terphenyl in cyclohexane or with $\text{N-}\text{acetyl}\text{-}\text{L}\text{-}\text{tryptophanamide}$ in pH 7.5 buffer. Serum albumins from human and bovine sources have been employed as examples for time resolved fluorescence spectra and for the demonstration of anisotropy decay curves. Using these methods protein dynamics in the (sub)nanosecond time region can be directly explored.