犬脑内动脉构筑的显微X线解剖学研究

犬脑11只,经生理盐水冲洗脑血管后,注入20％钡胶液,切成0.2～1.0厘米的厚片,用显微X线法研究犬脑内各级动脉的构筑,其结果:1.皮质动脉的管径平均为25.9±0.005微米,平均长度为888.0±0.241微米。其形态与发出部位有关,分别呈栅状和瓶刷状。2.髓质动脉的管径平均为49.9±0.007微米。呈直线或孤形向心走行。3.皮质下动脉的管径平均为38.7±0.009微米。呈新月形或蟹钳状分布。4.豆纹动脉和内囊动脉的平均管径为70.0±0.021微米。呈锐角、反血流方向发自母干,再呈“S”形上升。5.丘脑动脉的平均管径为63.7±0.019微米,主要从下方进丘脑,呈树枝状分支。     

The morphology,innervation and neural control of the anterior arterial system of Aplysia californica

Summary The morphology, innervation, and neural control of the anterior arterial system of Aplysia californica were investigated. Immunocytochemical and histochemical techniques generated positive reactions in the anterior arterial system for several neuroactive substances, including SCP_B, FMRFamide, R151 peptide, dopamine and serotonin. Three neurons were found to innervate the rostral portions of the anterior arterial tree. One is the identified peptidergic neuron R15 in the abdominal ganglion, and the other two are a pair of previously unidentified neurons, one in each pedal ganglion, named pedal arterial shorteners (P_AS)- The endogeneously bursting neuron R15 was found to innervate the proximal anterior aorta. It also innervates a branch of the distal anterior aorta, the left pedal-parapodial artery. Activity in R15 causes constriction of the left pedal-parapodial artery. This effect is presumed to direct hemolymph towards the genital groove and penis on the right side in vivo. This vasoconstrictor action of R15 is mimicked by the R151 peptide. The P_AS neuron pair causes longitudinal contraction of the rostral anterior aorta and the pedal-parapodial arteries. In vivo, the pair is active during behaviors involving head withdrawal and turning. By adjusting the length of the arteries during postural changes, the P_AS neurons may prevent disturbances in blood flow due to bending or kinking of the arterial walls.     

Pulsatile Flow Inside Moderately Elastic Arteries,Its Modelling and Effects of Elasticity

Pulsatile flow inside a moderately elastic circular conduit with a smooth expansion is studied as a model to understand the influence of wall elasticity in artery flow. The solution of the simultaneous fluid-wall evolution is evaluated by a perturbative method, where the zeroth order solution is represented by the flow in a rigid vessel; the first order correction gives the wall motion and induced flow modification without the need to solve the difficult coupled problem. Such an approach essentially assumes a locally infinite celerity, therefore it represent a good approximation for the fluid-wall interaction in sites of limited extent (branches, stenosis, aneurism, etc.), which include typical situations associated with vascular diseases. The problem is solved numerically in the axisymmetric approximation; the influence of wall elasticity on the flow and on the unsteady wall shear stress is studied in correspondence of parameters taken from realistic artery flow. Attention is posed to the role of phase difference between the incoming pressure and flow pulses.     

颈内动脉支架置入术对颈动脉狭窄患者认知功能影响的研究

目的：研究颈动脉狭窄对认知功能的影响,探讨颈动脉支架置入术（CAS）患者术后不同时期认知功能的变化及其可能的机制。方法：选取2010年1月至2012年12月我院神经内科收住的急性脑梗死（前循环）患者75例,按颈内动脉狭窄程度,分成无狭窄组,轻度狭窄组（狭窄程度〈30％）,中度狭窄组（30-69％）和治疗组（70．99％）,前三组给予药物治疗,治疗组同时给予颈内动脉支架置入术,应用蒙特利尔认知评估量表（MoCA）、简易精神状态检查表（MMSE）、搭火柴测验（stickTest）,对患者进行认知功能评估,比较术前、术后不同时期认知功能的变化,同时利用SPECT／CT对治疗组20例患者术后局部脑血流改善状况进行评价。结果：治疗组和对照组在术前比较MoCA总分、MMSE评分、StickTest评分,发现治疗组评分低于对照组,且随着颈动脉狭窄程度的加重,认知功能受损越明显;治疗组在术后1周与术前比较,评分反而降低,差异有统计学意义;术后3个月、术后6个月与术前比较,评分均有所提高,差异有统计学意义;通过SPECT／CT对治疗组术前感兴趣区血流量与同侧小脑平均脑血流量比较,术后再与同侧小脑比较,结果显示术后脑灌注明显改善。结论：颈动脉狭窄与血管性认知功能障碍有关,而且认知功能障碍的程度与颈动脉狭窄程度呈正相关,颈内动脉支架置入术可最终改善认知功能,尤其表现在视空间／执行能力,延迟回忆能力,注意力等方面。     

丹皮酚通过酸性鞘磷脂酶/ 神经酰胺通路改善血管紧张素II 所致动脉内 皮功能障碍

目的:探讨丹皮酚(Paeonol,Pae)对血管紧张素II(AngiotensinⅡ,AngⅡ)所致动脉内皮功能障碍的保护作用及其机制。方法:采用实时定量聚合酶链式反应(RT-PCR)和Westernblot检测酸性鞘磷脂酶(acidsphingomyelinase,ASM)基因及蛋白表达;采用免疫组织荧光检测血管环神经酰胺(ceramide,Cer)含量变化;采用血管环张力描记技术检测主动脉血管环的舒张功能;采用二氢乙啶荧光探针(dihydroethidium,DHE)检测血管环超氧阴离子(superoxideanion,O2-·)水平。结果:与对照组相比,AngⅡ孵育后主动脉对乙酰胆碱(acetylcholine,Ach)的舒张反应显著降低,Pae与AngⅡ共孵育则无明显改变;AngⅡ及Pae孵育后,动脉对硝普钠(sodiumnitroprusside,SNP)的舒张反应均无明显变化;AngⅡ孵育可增高动脉环O2-·水平,这一反应被Pae明显抑制;与对照组相比,AngⅡ孵育动脉ASMmRNA水平无明显改变,但蛋白表达显著增加,Cer含量显著增多,Pae与AngⅡ共孵育动脉ASM蛋白及Cer水平与对照组相比均无明显改变;采用神经酰胺酶抑制剂N-oleoylethanolamine(OEA)增加动脉Cer含量后,Pae降低动脉O2-·水平以及增强Ach舒张反应的效应被显著抑制。结论:Pae通过ASM/Cer通路改善AngⅡ所致动脉氧化应激增强和内皮功能障碍。     

平板运动试验对冠心病的诊断意义

目的:探讨平板运动试验(TET)对诊断冠状动脉粥样硬化性心脏病(冠心病)的临床意义。方法:对比分析217例疑诊或临床诊断冠心病患者的平板运动试验和选择性冠状动脉造影(CAG)结果。结果:以选择性冠状动脉造影为标准,平板运动试验敏感性为68.4%,特异性为88.4%,阳性预测值为77.1%,阴性预测值为82.9%。结论:简便、易行及无创的平板运动试验是诊断冠心病的重要手段。     

High accumulation of calcium in human uterine artery with aging

To elucidate compositional changes of the rami of the internal iliac artery with aging, the authors investigated age-related changes of the calcium content in the uterine, internal pudendal, umbilical, and obturator arteries by inductively coupled plasma-atomic emission spectrometry. After an ordinary dissection was finished, the uterine, internal pudendal, umbilical, and obturator arteries were resected from 10 female subjects, and the internal pudendal, umbilical, and obturator arteries were resected from 10 male subjects. The female subjects ranged in age from 52 to 96 yr, and the male subjects ranged in age from 63 to 88 yr. The calcium content in the uterine artery began to increase in the seventies and increased markedly in the nineties. In the internal pudendal artery, the calcium content hardly increased up to the eighties and increased significantly in the nineties. In contrast, the calcium content did not change in both the umbilical and obturator arteries with advancing age. It was found that the average content of calcium was the highest in the uterine artery and decreased in the order internal pudendal, umbilical, and obturator arteries. The average content of calcium in the uterine arteries corresponded to 46-fold the amount of the women's obturartor arteries, in which it was the lowest. In the cases of men, the average content of calcium was higher in the order of the internal pudendal, umbilical, and obturator arteries. Regarding the average content of calcium, the order internal pudendal, umbilical, and obturator arteries of the men was consistent with that of the women.     

Accumulation of calcium and phosphorus accompanied by inevitable accumulation of magnesium in human arteries

To examine whether there were differences between races in regard to the relationships among element contents in the arteries, the authors investigated the relationships among the average contents of calcium, phosphorus, sulfur, and magnesium in the 18 kinds of the Thai artery. After ordinary dissection by medical students at Chiang Mai University was finished, the thoracic and abdominal aortas, ramifying site of the abdominal aorta into the common iliac arteries, coronary, common carotid, internal thoracic, subclavian, axillary, brachial, radial, superior and inferior mesenteric, renal, common iliac, internal iliac, and external iliac arteries were resected from the subjects who consisted of 12 men and 3 women, ranging in age from 39 to 84 yr. The femoral and posterior tibial arteries were resected from the subjects, consisting of 15 men and 5 women, ranging in age from 25 to 88 yr. The element content of the arteries was analyzed by inductively coupled plasma-atomic emission spectrometry. It was found that there were extremely significant direct correlations among the average contents of calcium, phosphorus, and magnesium in the 18 kinds of the Thai artery, but no significant correlations were found between the average contents of sulfur and elements, such as calcium, phosphorus, and magnesium. These results were in agreement with those of the Japanese arteries. Therefore, it was suggested that there was no significant difference between the arteries of the Thai and the Japanese in the relationships among calcium, phosphorus, sulfur, and magnesium.     

RECK基因在兔颈动脉壁损伤后再狭窄过程中的表达

目的:通过建立动物损伤模型,分析RECK基因在兔子颈动脉球囊损伤术后的表达与动脉内膜变化和官腔狭窄的相关性。方法:兔子手术损伤侧的动脉血管设置为实验组,未进行手术操作的一侧动脉作为对照组。建立动脉模型的四个时间点7、14、21、28 d,在麻醉状态下处死模型动物。取得所需长度的损伤动脉血管及对照组动脉血管。将取得的标本进行HE病理染色,通过计算机图像计算软件观察标本动脉内膜随时间的变化;同时通过western-blot方法测定RECK蛋白表达水平、real-time PCR测量RECK基因表达量。结果:血管手术损伤后,血管内膜面积在随着术后日期的增长呈逐渐增厚变化,血管内膜与中层比值逐渐增大,同对照实验组比较,有统计学意义(P0.05)。实验组及对照组的中膜无显著增生。结论:RECK基因在组织中表达变化影响MMPs基因表达。实验论证了在动脉损伤后RECK基因参与了血管再狭窄,为血管再狭窄研究寻得新的研究方向。     

肌钙蛋白I水平检测对急诊房颤患者的临床意义

目的:探讨房颤患者急诊入院时检测肌钙蛋白I(Tn I)水平的临床作用及预测价值。方法:回顾性分析我院523例房颤患者的临床资料,将资料中数据进行统计学分析处理。患者分为三组:1组患者Tn I轻度升高;2组患者Tn I正常;3组患者未检测Tn I,分别就三组患者的基线特征以及就诊时的症状展开数据比较,并且单变量及多变量分析Tn I升高的预测因子。设置主要终点为1年内所有原因导致的死亡及心肌梗死(MI),患者从入院时起随访1年,记录期间的MI发生情况及死亡情况。结果:173例患者(33%)Tn I轻度升高(均值0.56 ng/m L),225例患者(43%)Tn I正常,125例患者(24%)未检测Tn I。住院期间1组患者(50%)的心功能检查异常明显高于组2和组3(28%和29%,P≤0.001),1组患者(22%)主要终点发生率明显高于2组(10%)和3组患者(15%)(P=0.002),有统计学意义。结论:肌钙蛋白I轻度升高与冠脉疾病(CAD)发生率增加及MI发生率增加有关,但对于总体死亡率无影响。