依那普利在大鼠单侧输尿管梗阻再通模型中的抗纤维化作用

目的:探讨依那普利对大鼠单侧输尿管梗阻再通模型肾脏纤维化的影响.方法:18只SD大鼠随机分为两组:假手术组(6只)以及单侧输尿管梗阻模型组(12只).输尿管梗阻3天后,实施梗阻再通手术,再将大鼠随机分为模型组(6只)以及依那普利组(6只),术后,依那普利组给予依那普利灌胃10mg/kg/d,假手术组以及模型组给予等量0.5%CM-CNa溶液灌胃.用药2周后,取术侧肾组织做HE染色,并采用Raford评分系统对肾间质损伤程度进行评分;用Real-timePCR方法检测Ⅰ、Ⅲ型胶原以及CT-GFmRNA的表达;用Westemblot方法检测CTGF蛋白水平的表达.结果:模型组大鼠肾脏损伤程度,Ⅰ、Ⅲ型胶原mRNA表达水平,以及CTGFmRNA和蛋白表达水平均比假手术组明显上升(P<0.01).经依那普利治疗后,与模型组相比,以上指标均显著下降(P<0.01).结论:依那普利能有效阻止大鼠单侧输尿管梗阻再通后肾脏纤维化的进展.依那普利抗纤维化的作用机制可能与抑制CTGF的表达有关.     

Implantation of Total Artificial Heart in Congenital Heart Disease

In patients with end-stage heart failure (HF), a total artificial heart (TAH) may be implanted as a bridge to cardiac transplant. However, in congenital heart disease (CHD), the malformed heart presents a challenge to TAH implantation. In the case presented here, a 17 year-old patient with congenital transposition of the great arteries (CCTGA) experienced progressively worsening HF due to his congenital condition. He was hospitalized multiple times and received an implantable cardioverter defibrillator (ICD). However, his condition soon deteriorated to end-stage HF with multisystem organ failure. Due to the patient''s grave clinical condition and the presence of complex cardiac lesions, the decision was made to proceed with a TAH. The abnormal arrangement of the patient''s ventricles and great arteries required modifications to the TAH during implantation.With the TAH in place, the patient was able to return home and regain strength and physical well-being while awaiting a donor heart. He was successfully bridged to heart transplantation 5 months after receiving the device. This report highlights the TAH is feasible even in patients with structurally abnormal hearts, with technical modification.     

Abundance patterns of filter-feeding Caddisflies (Trichoptera : Hydropsychidae) and seston in a Montana (U.S.A.) lake outlet

The abundance patterns of four species of net-spinning caddisflies (Trichoptera : Hydropsychidae) were studied in a Montana (U.S.A.) lake outlet stream. Total Hydropsychidae reached very high densities (X > 1400 / 0.2 m²) near the lake outfall but declined precipitously downstream. Abundance patterns generally agree with a published model of filter-feeder / seston interactions in lake outlets. Larval densities were greater on moss-covered substrates and one species occupied habitats of lower water velocity compared to other species. Seston concentrations increased downstream contrary to expectation. Nutrient quality of seston may be important in predicting abundance of stream filter-feeders.     

Agarwood Induced Laxative Effects via Acetylcholine Receptors on Loperamide-Induced Constipation in Mice

Agarwood (Aquilaria sinensis, Aquilaria crasna) is well known as an incense in the oriental region such as Thailand, Taiwan, and Cambodia, and is used as a digestive in traditional medicine. We investigated the laxative effects and mechanism of agarwood leaves extracted with ethanol (EEA-1, Aquilaria sinensis; EEA-2, Aquilaria crasna). EEA-1, EEA-2, the main constituents of EEAs (mangiferin, and genkwanin-5-O-primeveroside), and senna increased the frequency and weight of stools in loperamide-induced constipation model mice. EEA-1 and EEA-2 did not induce diarrhea as a side effect, but senna induced severe diarrhea. EEA-1 and senna increased gastro-intestinal (GI) transit in the model mice. EEA-1, but not senna, also increased the intestinal tension of isolated jejunum and ileum in guinea pigs, and the tension increase was blocked by atropine, a muscarinic receptor antagonist, but not by other inhibitors (granicetron, pyrilamine, or bradykinin-antagonist peptide). Furthermore, the increase in frequency and weight of stools induced by EEA-1 were blocked by pre-administration of atropine in the model mice. These findings indicate that EEAs exerted a laxative effect via acetylcholine receptors in the mouse constipation model.     

Plasma carbonyls do not correlate with lung function or computed tomography measures of lung density in older smokers

Abstract

Oxidative stress and inflammation are hallmarks of chronic obstructive pulmonary disease (COPD). A critical byproduct of oxidative damage is the introduction of carbonyl groups into amino acid residues. We hypothesize that plasma carbonyl content is inversely correlated with lung function and computed tomography (CT) measures of lung density among smokers and is elevated in COPD. Carbonyl was measured in plasma of participants aged 60 years and older by ELISA. Generalized linear and additive models were used to adjust for potential confounders. Among 541 participants (52% male, mean age 67 years, 41% current smokers), mean plasma carbonyl content was 17.9±2.9 nmol ml^?1 and mean forced expiratory volume in one second (FEV₁) was 80.7±20.9% of predicted. Plasma carbonyl content was inversely associated with FEV₁, but this relationship was largely explained by age. Multivariate analyses ruled out clinically meaningful associations of plasma carbonyl content with FEV₁, FEV₁/FVC (forced vital capacity) ratio, severity of airflow obstruction, and CT lung density. Plasma carbonyl content is a poor biomarker of oxidative stress in COPD and emphysema.     

小鼠脾虚便秘造模对肠道微生物及酶活性的影响

目的研究小鼠脾虚便秘造模对肠道微生物及酶活性的影响,为脾虚便秘的治疗提供基础。方法采用灌胃番泻叶水煎液7 d,然后控制饮食,饥饱失常;正常组灌胃等量的无菌水7 d后正常喂养,共15 d,制备小鼠脾虚便秘模型。分析小鼠体重、肠道菌群和酶活性的变化情况。结果模型组小鼠体重、体重变化率均显著小于正常组(P<0.05或P<0.01);肠道细菌总数显著小于正常组(P<0.01),大肠埃希菌、乳酸菌、双歧杆菌数和真菌均显著大于正常组(P<0.05或P<0.01);肠道淀粉酶和蛋白酶活性显著低于正常组(P<0.05或P<0.01),木聚糖酶和纤维素酶则显著高于正常组(P<0.01)。结论小鼠脾虚便秘造模影响小鼠的体重,破坏了肠道微生物的平衡,并影响肠道酶活性。     

粪菌移植联合乳果糖对顽固性功能性便秘患者胃肠功能、生活质量及心理状态的影响*

目的:研究粪菌移植联合乳果糖对顽固性功能性便秘患者胃肠功能、生活质量及心理状态的影响。方法:选取2016年6月至2018年5月我院消化内科收治的顽固性功能性便秘患者100例为研究对象,按照随机数字表法将患者分为对照组(n=45)和研究组(n=55)。对照组给予乳果糖口服治疗,研究组则采用粪菌移植联合乳果糖治疗,两组均治疗6周。对比两组临床疗效、胃肠功能以及治疗前后生活质量和心理状态的变化,并观察两组治疗期间不良反应发生情况。结果:与对照组比较,研究组总有效率明显升高(P0.05)。研究组首次自主排便时间、肛门首次排气时间、肠鸣音恢复时间均短于对照组,胃肠减压引流量高于对照组(P0.05)。治疗6周后,两组患者生活质量自评量表(PAC-QOL)评分、Zung焦虑自评量表(SAS)评分和抑郁自评量(SDS)评分均较治疗前降低,且与对照组比较,研究组PAC-QOL评分、SAS评分、SDS评分均降低(P0.05)。两组不良反应发生率比较差异无统计学意义(P0.05)。结论:粪菌移植联合乳果糖对顽固性功能性便秘具有较好的疗效,可改善患者胃肠功能和心理状态,同时可提高患者生活质量,无严重不良反应发生。     

实时三维超声造影对输卵管伞端通畅性及功能的评价效果

目的:探讨实时三维超声造影对输卵管伞端通畅性及功能的评价效果。方法:选取我院2019年6月到2021年6月收治的120例因不孕症自愿接受RT 3D-HyCoSy检查的患者作为研究对象,对所有患者分别应用静态三维与实时三维超声造影,并以腹腔镜下美兰通染液检查作为金标准,记录与分析相关指标。结果:120例患者共240条输卵管,美兰通染液检查诊断发现输卵管通畅58条,阻塞/粘连182条,实时三维超声造影检查发现通畅51条,阻塞/粘连189条,静态三维通畅44条,阻塞/粘连196条,实时三维超声造影与静态三维联合通畅56条,阻塞/粘连184条。实时三维超声造影与静态三维联合诊断组、实时三维超声造影组这两组的准确度、特异度、灵敏度、阳性预测值、阴性预测值均高于静态三维组(P<0.001);120名患者通过临床综合诊断发现,35例一侧输卵管阻塞患者,64例双侧输卵管阻塞患者,21例双侧输卵管通畅患者,不同输卵管通畅性三组患者推注压力、VAS评分、造影剂注入量、造影剂返流量对比差异显著(P<0.05)、通畅与阻塞患者造影剂通过输卵管间质部时间及造影剂通过输卵管伞端时间对比差异显著(P<0.05)。结论:对于不孕症患者应用RT 3D-HyCoSy,经检查输卵管伞端粘连和通畅性,进而诊断输卵管通畅性,为不孕症的诊断与治疗提供一定的参考意见。此外,应用实时三维超声造影与静态三维超声能提升输卵管伞端通畅性诊断率,值得临床应用推广。     

润肠通便合剂对便秘模型小鼠结肠MUC2、AQP3的影响*

目的: 研究润肠通便合剂对便秘模型小鼠的治疗作用及对结肠黏蛋白(MUC2)、水通道蛋白(AQP3)表达的影响。方法: 将小鼠分为空白对照组、模型对照组、阳性对照组及润肠通便合剂高、中、低剂量组(40、20、10 ml/kg)(n=10),通过复方地芬诺酯(30 mg/kg灌胃1次或20 mg/kg灌胃14 d)来复制便秘动物模型,观测润肠通便合剂给药3 d对便秘小鼠排便、小肠推进的影响,给药14 d对便秘小鼠结肠病理学、含水量、结肠灌洗液(CLAF)中Muc2以及结肠AQP3基因表达水平,观测润肠通便合剂给药3 d或14 d对便秘小鼠排便、小肠推进、结肠病理学、含水量、结肠灌洗液(CLAF)中Muc2以及结肠AQP3基因表达水平的影响。结果: 与空白对照组比较,模型对照组小鼠给予30 mg/kg复方地芬诺酯1次后,小肠推进长度及推进率显著降低,首便时间延长,6 h排便粒数减少;给予20 mg/kg复方地芬诺酯14 d后,小鼠结肠出现明显病理学变化,CLAF中Muc2的含量降低,近端结肠AQP3的基因表达水平升高,结肠湿干重比值降低(P＜0.01)。与模型对照组比较,给予润肠通便合剂能明显增加小肠推进长度及推进率,缩短首便时间,增加6 h排便粒数,改善便秘小鼠结肠病理学,提高CLAF中Muc2的含量,抑制近端结肠AQP3的基因表达,提高结肠湿干重比值(P＜0.05, 0.01)。结论: 润肠通便合剂可加速排便,改善结肠病理学,其中促进Muc2分泌、下调AQP3 mRMA表达而改善结肠水代谢是其通便的机制之一。