康复训练联合高压氧对高血压脑出血术后患者脑血管动力学、血管内皮功能和血清NSE、UCH-L1、GFAP的影响

摘要 目的：观察康复训练联合高压氧对高血压脑出血术后患者脑血管动力学、血管内皮功能和血清神经元特异性烯醇化酶（NSE）、泛素羧基端水解酶（UCH-L1）、神经胶质纤维酸性蛋白（GFAP）的影响。方法：按照随机数字表法将2021年3月~2022年12月我院收治的112例行微创钻孔置管引流术的高血压脑出血术后患者分为对照组（n=56,接受常规康复训练）和观察组（n=56,对照组基础上结合高压氧干预）。对比两组量表评分[日常生活能力量表-改良Barthel指数（MBI）、Fugl-Meyer运动功能评定量表（FMA）、美国国立卫生研究院卒中量表（NIHSS）]、脑血管动力学指标[平均血流量（Qmean）、外周阻力（R）、平均血流速度（Vmean）]、血管内皮功能[内皮素-1（ET-1）、一氧化氮（NO）]、血清NSE 、UCH-L1、GFAP水平以及不良反应发生情况。结果：与对照组干预后相比,观察组MBI、FMA评分更高,NIHSS评分更低（P<0.05）。与对照组干预后相比,观察组Vmean、Qmean更高,R更低（P<0.05）。与对照组干预后相比,观察组NSE、UCH-L1、GFAP更低（P<0.05）。与对照组干预后相比,观察组NO更高,ET-1更低（P<0.05）。两组不良反应发生率对比未见差异（P>0.05）。结论：康复训练联合高压氧干预高血压脑出血术后患者,可有效改善脑血管动力学、血管内皮功能和血清NSE、UCH-L1、GFAP水平,减轻神经功能损伤,提高生活自理能力。     

Organization of cells and extracelluar matrix in mesenteric arteries of spontaneously hypertensive rats

Summary Biochemical studies have been used to assess the quantitative changes in elastin and collagen in hypertensive vs. normotensive arteries. However, the relative distribution and organization of these fibrous proteins is likely to be equal in importance to their absolute amounts. In this study we have used scanning electron microscopy in association with selective digestion techniques to assess the organization of cellular and extracellular components of the tunica media of mesenteric arteries of spontaneously hypertensive rats. Superior and small mesenteric arteries were digested with acid, alkali, or bleach to exposure cells, collagen, or collagen and elastin, respectively. We observed that hypertension does not cause a qualitative change in the 3-dimensional arrangement of cells, collagen, or elastin in spontaneously hypertensive arteries when compared to normotensive arteries. However, cells in the superior artery are significantly different in overall shape and surface features when compared to cells of small arteries. These differences in surface morphology of cells are present in hypertensive and normotensive vessels and suggest that superior and small mesenteric artery cells transmit load to the isotropic matrix in different ways. In the elasto-muscular superior artery, force is transmitted across digitations throughout the cell surface. In the muscular small artery, force is transmitted across the tapered, smooth cell surface.     

Decreased number of beta-adrenergic receptors in hypertensive vessels

Responsiveness to inotropic agents is altered in hypertension and may contribute to its initiation and maintenance. A biochemical basis for this change was provided by the observation that the number of β-adrenergic receptors, as reflected in specific [³H]dihydroalprenolol binding, was diminished in both arteries and veins of spontaneously hypertensive rats. There was no change in the affinity of dihydroalprenolol for the binding sites or in the capacity of isoproterenol to displace dihydroalprenolol. The decline in β-adrenergic receptor numbers is not secondary to blood pressure elevation but may, instead, contribute to the pathogenesis of hypertension.     

降压通络方对大鼠肾小管上皮细胞凋亡的影响

目的:研究降压通络方对大鼠肾小管上皮细胞凋亡的影响。方法:体外培养大鼠肾小管上皮细胞,经过缺血缺氧,将大鼠肾小管细胞随机分为4组:正常组、模型组、降压通络方组、缬沙坦组。采用CCK-8检测细胞增殖情况,免疫组化法检测大鼠肾小管上皮细胞p-AKT蛋白的表达,蛋白免疫印迹法检测大鼠肾小管上皮细胞凋亡相关基因调控蛋白Bcl-2、Bax的表达,对Bcl-2、Bax蛋白的表达水平进行相关性分析。结果:缺血缺氧呈时间依赖性抑制大鼠肾小管上皮细胞活性;免疫组化结果示:p-AKT在正常组呈高表达,模型组低表达,降压通络方组p-AKT表达明显高于模型组(P0.01),缬沙坦组表达低于模型组(P0.05);蛋白免疫印迹法结果示:模型组Bcl-2表达较正常组明显降低(P0.01),降压通络方组和缬沙坦组Bcl-2的表达均高于模型组(P0.05,P0.01);模型组Bax表达较正常组明显升高(P0.01),降压通络方组和缬沙坦组Bax的表达均较模型组降低(P0.05);Bcl-2蛋白与Bax蛋白表达呈负相关性(r=-0.811,P0.01)。结论:降压通络方可抑制大鼠肾小管上皮细胞凋亡,其作用机制可能与上调p-AKT、Bcl-2蛋白,下调Bax蛋白表达有关。     

Effects of 2-hydroxyoleic acid on the structural properties of biological and model plasma membranes

Genetic hypertension is associated with alterations in lipid metabolism, membrane lipid composition and membrane-protein function. 2-Hydroxyoleic acid (2OHOA) is a new antihypertensive molecule that regulates the structure of model membranes and their interaction with certain peripheral signalling proteins in vitro. While the effect of 2OHOA on elevated blood pressure is thought to arise through its influence on signalling proteins, its effects on membrane lipid composition remain to be assessed. 2OHOA administration altered the lipid membrane composition of hypertensive and normotensive rat plasma membranes, and increased the fluidity of reconstituted liver membranes from hypertensive rats. In spontaneously hypertensive rats (SHR), treatment with 2OHOA increased the cholesterol and sphingomyelin content while decreasing that of phosphatidylserine-phosphatidylinositol lipids. In addition, monounsaturated fatty acid levels increased as well as the propensity of reconstituted membranes to form H_II-phases. These data suggest that 2OHOA regulates lipid metabolism that is altered in hypertensive animals, and that it affects the structural properties of liver plasma membranes in SHR. These changes in the structural properties of the plasma membrane may modulate the activity of signalling proteins that associate with the cell membrane such as the Gαq/11 protein and hence, signal transduction.     

Specific decrease of secretin/VIP-stimulated adenylate cyclase in the heart from the Lyon strain of hypertensive rats

The cardiac adenylate cyclase activity of genetically hypertensive rats from the Lyon strain (LH) was compared to that of Lyon normotensive rats (LN) and that of low blood pressure Lyon rats (LL). The major finding was a 30-35% decrease of secretin- and VIP-stimulated adenylate cyclase activity in cardiac membranes of LH rats that was already obvious in 5 week-old prehypertensive animals: this alteration was apparently specific for the cardiac secretin/VIP-stimulated adenylate cyclase activity, the same activity in membranes from brain, anterior pituitary, and liver being similar in LH, LN and LL rats. It is tempting to conclude that a selective alteration of functional cardiac secretin/VIP receptors in LH rats reflects a local hyperactivity of the sympathetic adrenergic system.