The effect of perfusion on soft tissue mechanical properties: a computational model

Some simple finite element models were constructed to investigate the magnitude and character of changes in mechanical properties of very soft tissues due to the loss of perfusion. Changes in the apparent stress-strain curve were used to characterise the effect of simulated blood perfusion pressure on the engineering stress-strain curve. The results indicated that the blood to tissue volume ratio and the perfusion pressure have the strongest effect on the effective stress-strain response of a representative tissue cell. Tissue viscoelasticity increased the sensitivity of the system to perfusion pressure changes.     

Effect of Defocused CO2 Laser on Equine Tissue Perfusion

   

Treatment with defocused CO₂ laser can have a therapeutic effect on equine injuries, but the mechanisms involved are unclear. A recent study has shown that laser causes an increase in equine superficial tissue temperature, which may result in an increase in blood perfusion and a stimulating effect on tissue regeneration. However, no studies have described the effects on equine tissue perfusion. The aim of the present study was to investigate the effect of defocused CO₂ laser on blood perfusion and to correlate it with temperature in skin and underlying muscle in anaesthetized horses. Differences between clipped and unclipped haircoat were also assessed. Eight horses and two controls received CO₂ laser treatment (91 J/cm²) in a randomised order, on a clipped and unclipped area of the hamstring muscles, respectively. The significant increase in clipped skin perfusion and temperature was on average 146.3 ± 33.4 perfusion units (334%) and 5.5 ± 1.5°C, respectively. The significant increase in perfusion and temperature in unclipped skin were 80.6 ± 20.4 perfusion units (264%) and 4.8 ± 1.4°C. No significant changes were seen in muscle perfusion or temperature. In conclusion, treatment with defocused CO₂ laser causes a significant increase in skin perfusion, which is correlated to an increase in skin temperature.     

保留假包膜对宫腔镜下粘膜下子宫肌瘤切除术后瘢痕区血流灌注的影响

目的:探究在宫腔镜下粘膜下子宫肌瘤切除术中保留假包膜对术后瘢痕区血流灌注的影响。方法:选取2016年8月～2018年9月我院收治的子宫肌瘤患者80例为研究对象,根据随机数字表法将患者分为两组,对照组患者40例在手术过程中不保留假包膜,观察组患者40例在手术过程中保留假包膜。比较两组患者手术相关指标(手术时间、术中出血量、排气时间和下床活动时间)、术后瘢痕变化情况、瘢痕区域的血流灌注情况及并发症的发生情况。结果:两组患者的手术时间、术中出血量、排气时间和下床活动时间相比均无统计学差异(P0.05)。随着术后时间的推移,两组患者的瘢痕区逐渐缩小,且观察组患者的瘢痕愈合程度高于对照组(P0.05)。观察组患者术后的血管指数(VI)、血流指数(FI)和血管化血流指数(VFI)值均显著低于对照组(P0.05)。两组患者的并发症发生率比较无统计学差异(P0.05)。结论:在宫腔镜下粘膜下子宫肌瘤切除术中保留假包膜与不保留假包膜的手术效果相当,但保留假包膜可显著改善患者瘢痕区域的血流灌注,促进创面愈合,且不增加并发症的发生率。     

体素内不相干运动成像对于周围型肺癌血供情况及细胞密集程度的价值研究

摘要 目的：探究周围型肺癌3.0 T磁共振成像（MRI）的体素内不相干运动成像（IVIM-DWI）各参数值对其血供情况以及细胞密集程度的价值。方法：选取2019年1月-2021年10月于本院行手术切除后并经病理检查证实为周围型肺癌的患者50例,术前均行常规MRI平扫、增强以及IVIM-DWI成像,分别测量所有病灶以及对侧相对称正常肺组织的标准表观扩散系数（sADC）、真实扩散系数（D）、灌注相关扩散系数（Ｄ*）以及灌注分数（?）。比较两者IVIM-DWI参数;比较不同强化程度下周围型肺癌病灶IVIM-DWI参数;Spearman 秩相关分析周围型肺癌病灶IVIM-DWI参数与强化程度的相关性;通过绘制受试者工作特征（ROC）曲线,分析与强化程度存在相关性的IVIM-DWI参数对周围型肺癌血供情况及细胞密集程度的评估价值。结果：周围型肺癌病灶的sADC、D均低于正常肺组织,D*、?均高于正常肺组织,差异均具有统计学意义（P<0.05）。高度强化下周围型肺癌病灶D*高于中度强化、轻度强化,?低于中度强化、轻度强化,而D仅高于轻度强化,差异均具有统计学意义（P<0.05）,不同强化程度间sADC均无统计学差异（P>0.05）。Spearman秩相关分析显示周围型肺癌病灶的D*与强化程度呈正相关（P<0.05）,?与强化程度呈负相关（P<0.05）。通过绘制ROC曲线分析显示D*、?对周围型肺癌血供情况以及细胞密集程度评估的AUC大于0.700,提示其具有较高的评估价值。结论：IVIM-DWI模型既可以反映周围型肺癌的血供情况,也可以反映病变细胞密集程度,有助于提高对周围性肺癌血管情况及细胞密集程度的评估价值。     

控制性低温麻醉联合PiCCO监测对创伤性失血性休克患者的脑组织灌注和耗氧量的影响

摘要 目的：探讨控制性低温麻醉联合脉搏指数轮廓心输出量（PiCCO）监测对创伤性失血性休克患者的脑组织灌注和耗氧量的影响。方法：前瞻性选择2018年7月至2021年11月期间入住我院急诊重症监护病房的120名创伤性失血性休克患纳入本研究。根据随机数字表法,分为常温组（常温麻醉联合PiCCO监测）和低温组（控制性低温麻醉联合PiCCO监测）。PiCCO同时测量的心输出量（CO）和心脏指数（CI）。统计创伤性失血性休克患者耗氧量。通过动脉导管或血压袖带测量平均动脉压（MAP）。使用EVD测量颅内压（ICP）。脑灌注压为MAP和ICP之间的差值。通过Armstrong和 Al-Awadi方法测量MDA水平。通过分光光度方法测量NO水平。通过恒流过滤器系统测量ED指数。通过ELISA测量Caspase-3、Caspase-9、IL-6和IL-8的水平。对创伤性失血性休克患者急性呼吸窘迫综合征（ARDS）、多脏器功能衰竭（MODS）和死亡率统计。结果：低温组CO和CI较常温组升高（P<0.05）。低温组干预前DO₂、VO₂和SvO₂与常温组比较无统计性差异（P>0.05）。低温组与常温组干预后DO₂、VO₂和SvO₂均较干预前升高（P<0.05）。低温组干预后DO₂、VO₂和SvO₂较常温组升高（P<0.05）。低温组0 h脑灌注压与常温组比较无统计性差异（P>0.05）。低温组1 h、2 h和3 h脑灌注压较常温组升高（P<0.05）。低温组MDA、NO和ED较常温组降低（P<0.05）。低温组Caspase-3、Caspase-9、IL-6和IL-8水平较常温组降低（P<0.05）。低温组ARDS、MODS和死亡率较常温组降低（P<0.05）。结论：控制性低温麻醉联合PICCO监测通过调节细胞凋亡途径和炎症因子分泌,增加创伤性失血性休克患者脑组织灌注和耗氧量,降低患者ARDS、MODS发生率和死亡率。     

Effects of compound lobelia oral liquid on acute pharyngitis rabbits model

AimsExplore the effect of compound lobelia oral liquid on acute pharyngitis rabbits model caused by ammonium hydroxide, evaluate its curative effect.MethodsAcute pharyngitis rabbit model was prepared by ammonia spray at pharyngeal. After 1 h of the last administration, score the pharyngeal tissue symptoms of rabbits under the condition of naked eyes (score according to the score criteria). Then, take blood from the marginal auricular vein for routine blood tests and serum TNF-α level measure. Take pharyngeal tissue for HE staining, and observe its pathological changes under the microscope.ResultsCompared with the blank group, the pharyngeal tissue symptom score and serum TNF-α level in the model group were significantly increased (P < 0.01). The results of blood routine showed that the number of white blood cells and lymphocytes in the model group increased significantly (P < 0.01), and neutrophilic granulocyte percentage decreased significantly (P < 0.01). The infiltration of inflammatory cells in the pharynx tissue was obvious and pathological changes were observed. Compared with the model group, large, middle and small doses of compound lobelia oral liquid group could reduce the scores of pharyngeal tissue symptoms in rabbits with acute pharyngitis induced by ammonia. The large and middle dose compound lobelia oral liquid group could significantly reduce serum TNF-α level and neutrophilic granulocyte percentage, significantly increase the number of white blood cells and lymphocytes (P < 0.01); The small dose compound lobelia oral liquid group could significantly reduce the number of white blood cells and lymphocytes (P < 0.01), there was an increasing tendency to neutrophils and a decreasing tendency to serum TNF-α, but no statistical significance. The large, middle and small doses of compound lobelia oral liquid group all could improve the pathological changes of pharyngeal tissue inflammatory infiltration.ConclusionCompound lobelia oral liquid has a good effect on rabbit acute pharyngitis model caused by ammonia.     

松龄血脉康对1级高血压合并睡眠障碍患者的临床疗效

目的:探讨松龄血脉康对1级高血压合并睡眠障碍患者生活质量及临床疗效的影响。方法:收集我院收治的150例1级高血压合并睡眠障碍患者,随机分为实验组和对照组,每组75例。对照组患者给予硝苯地平缓释片并结合低盐饮食,减少脂肪摄入,减轻体重,增加体育活动等。实验组患者在对照组患者基础上给予松龄血脉康胶囊。观察并比较两组患者的治疗前后血压、生活质量水平以及患者睡眠障碍、高血压的临床疗效。结果:与治疗前相比,两组患者治疗后收缩压、舒张压水平均下降,生活质量评分均升高,差异具有统计学意义(P0.05);与对照组相比,实验组患者收缩压、舒张压水平较低,生活质量评分、睡眠障碍以及高血压的治疗有效率较高,差异具有统计学意义(P0.05)。结论:松龄血脉康能够降低1级高血压合并睡眠障碍患者血压水平,提高其生活质量,提高治疗效果。     

Influence of the arachidonic acid cascade on the in vitro hepatic response to hypoxia

Studies were undertaken to determine the effect of arachidonic acid, the precursor of bisenoic prostanoic acid derivatives, on the response of the isolated, perfused rabbit liver to hypoxia. Two and one half hours of severe hypoxia resulted in significant increases in hepatic vascular perfusion pressure, tissue wet weight, and the rates of cellular loss of lactic dehydrogenase, malic dehydrogenase, and acid phosphatase into the perfusing medium. Hypoxia also increased the rate of hepatic PGF_2α production by 25% after 2 hours (p<0.05, hypoxia vs sham). The addition of arachidonic acid (0.1 μg/g/min for 150 minutes) to the perfusion medium of hypoxic livers significantly attenuated the changes in perfusion pressure, tissue wet weight, and loss of cellular enzymes. Arachidonic acid administration increased the rate of PGF_2α production by 100% (p<0.05, sham vs hypoxia + arachidonic acid) within 30 min after hypoxia and maintained this rate for the duration of the study. These results demonstrate that hypoxia mediated prostaglandin F_2α synthesis in the rabbit liver can occur in the absence of neural and blood borne components and that significant activation of the arachidonic acid cascade via the administration of exogenous arachidonic acid has a salutary effect on hepatic hemodynamics and cellular integrity during hypoxia.     

一种猪模型的体外肺灌注系统的建立

目的:体外肺灌注技术(Ex vivo lung perfusion, EVLP)对于肺移植的实施意义重大,但成本昂贵。本文采用国产经济材料建立猪模型的EVLP系统,以探索保证系统性能的同时降低移植费用。方法:我们首先依据国产材料配置肺灌注液,并组装管道、连接仪器以建立EVLP系统;之后通过外科手段获得3头家猪的肺脏,并灌注肺灌注液,低温保存6小时;最后我们将肺脏连接到EVLP系统,通过血气分析和肺功能检查来评估肺脏随时间变化的状况。结果:离体并在低温保存6小时的猪肺脏,通过我们建立的相对经济的EVLP系统,可以在2小时内维持良好的氧合功能和肺生理指标:肺动脉压、气道峰压、平台压力、肺动脉氧气分压和二氧化碳分压和左心房的氧气分压和二氧化碳分压都保持稳定,同时肺脏具有正常的颜色和弹性,没有明显水肿和功能损害。结论:我们建立的EVLP系统可以有效地维护离体猪肺的生理功能,且降低了成本,从而为肺移植体外肺灌注技术的优化应用提供了研究基础。     

Protective effect of thioredoxin perfusion but not inhalation in warm ischemic-reperfused rat lungs

Abstract

Background: Thioredoxin is a ubiquitous protein with anti-oxidative, anti-apoptotic, and anti-inflammatory effects. It was reported [Fukuse T, Hirata T, Yokomise H et al. Attenuation of ischaemia reperfusion injury by human thioredoxin. Thorax 1995; 50: 387–391] that rhTRX protected lungs from ischemia-reperfusion injury as a radical scavenger; however, the mechanism was not elucidated. Therefore, we investigated the effect of perfusion and inhalation of rhTRX, and the associated mechanisms, by analyzing the concentrations and molecular states of the perfused rhTRX.

Materials and methods: Perfusion and inhalation studies of rhTRX were conducted with an isolated rat-lung perfusion model. The heart-lung block was perfused for 15 min and subsequently exposed to a 55-min ischemia followed by a 120-min reperfusion. Pulmonary artery pressure, weight gain, dynamic airway resistance, pulmonary compliance, and tidal volume were measured continuously. The concentrations and molecular states of the perfused rhTRX were measured.

Results: A 350-μg/ml perfusion of rhTRX decreased post-ischemic pulmonary artery pressure (P < 0.05), while a 200-μg/ml perfusion did not. Throughout the experiment, the rhTRX concentrations were constant, and the rhTRX molecules were mostly dimeric. The inhalation of rhTRX showed adverse effects on the pulmonary function compared with the control group (P < 0.05).

Conclusions: A 350-μg/ml perfusion, but not inhalation, of rhTRX protected rat lungs from ischemia-reperfusion injury. rhTRX was effective in dimeric form without transit to the lung tissue. rhTRX may be effective by some mechanism other than radical scavenging.     

氨氯地平联合厄贝沙坦治疗老年糖尿病伴高血压的疗效及对糖脂代谢和心肌损伤指标的影响

目的:探讨氨氯地平联合厄贝沙坦治疗老年糖尿病伴高血压的疗效及对糖脂代谢和心肌损伤指标的影响。方法:选择我院2017年9月～2019年12月收治的98例老年糖尿病伴高血压患者,依据随机数字表法分为对照组和治疗组,每组各49例。对照组给予氨氯地平治疗,治疗组在对照组的基础上联合厄贝沙坦治疗,对比两组的临床疗效,治疗前后血压、血糖、血脂、心肌损伤指标的变化以及不良反应的发生情况。结果:治疗后,治疗组显效率为67.35%,显著高于对照组,差异有统计学意义(P0.05)。治疗后,两组收缩压、舒张压、空腹血糖、糖化血红蛋白、总胆固醇、三油甘酯、心肌肌钙蛋白I、肌酸激酶同工酶、乳酸脱氢酶水平均较治疗前明显下降,且治疗组以上指标均明显低于对照组(P0.05)。两组不良反应总发生率比较差异无统计学意义(P0.05)。结论:氨氯地平联合厄贝沙坦能够提高老年糖尿病伴高血压的效果,改善糖脂代谢及减轻心肌损伤。     

Autologous bone marrow mononuclear cell therapy improves symptoms in patients with end-stage peripheral arterial disease and reduces inflammation-associated parameters

Background aimsThe purpose of this study was to evaluate the effect of autologous bone marrow mononuclear cells (BM-MNCs) on symptoms and perfusion indices in severely symptomatic patients with peripheral arterial disease (PAD) without further option for endovascular or surgical revascularization.MethodsOnly patients with severe symptomatic PAD (Fontaine class IIb-IV, Rutherford category 3–6) not amenable for revascularization were treated. Bone marrow from both cristae iliacae was harvested; MNCs were isolated by the Ficoll density-gradient method and transplanted by means of intra-arterial and intramuscular injection in the index limb. Functional (pain score, ulcer healing, maximum walking distance) and perfusion indices such as ankle-brachial-index and transcutaneous oxygen pressure were documented before and after BM-MNC therapy. Additionally, serum concentration of C-reactive protein and interleukin-6 were measured as markers of inflammation before and after BM-MNC treatment.ResultsSixteen consecutive patients (four women; mean age, 63.0 ± 13 years) were treated with a mean dose of 4.2 ± 2.2 × 10⁸ BM-MNCs. At 6 months' follow-up, ankle-brachial-index, transcutaneous oxygen pressure and maximum walking distance significantly increased, whereas C-reactive protein and interleukin-6 conversely decreased (P < 0.01 versus baseline values), resulting in 88% limb salvage, 75% pain reduction and 71% complete wound healing and/or reduction of ulcer size. One major and one minor amputation were performed, both in patients with Rutherford category 6.ConclusionsAutologous BM-MNC therapy in patients with end-stage PAD improves tissue perfusion indices and decreases markers of inflammation. If our observations could be confirmed by large-scale, randomized controlled trials, BM-MNC transplantation could become an alternative therapeutic option for patients with end-stage PAD.     

Effect of magnesium sulfate administration on subendocardial and subepicardial perfusion

The objective of this study was to determine the effect of systemic MgSO₄ infusion on subendocardial and subepicardial perfusion. Seventeen spontaneously breathing piglets were examined. Myocardial perfusion was measured using radiolabeled microspheres at baseline, 30 and 60 min after either MgSO₄ (80 mg/kg) or saline infusion. Blood pressure, heart rate, and cardiac output were also measured at these time intervals. Comparison of the magnesiuminduced changes in systemic blood pressure and on subendocardial and subepicardial perfusion at 30 and 60 min with values obtained with saline solution at 30 and 60 min, yielded no statistically significant difference (Tables 1–3). The ratio of subendocardial/subepicardial blood flow and subendocardial and subepicardial coronary vascular resistance at 30 and 60 min revealed no statistically significant differences between the magnesium and the control group (Table 3). There were no statistically significant difference in cardiac output and heart rate during any of the measured periods (Table 2). Our results suggest that the administration of MgSO₄ does not alter the ratio of subendocardial/subepicardial blood flow and the ratio of subendocardial/subepicardial coronary vascular resistance.     

低钠透析联合血液透析滤过对终末期肾脏病合并顽固性高血压患者血压节律、钙磷代谢的影响

目的:探讨低钠血液透析(hemodialysis,HD)联合血液透析滤过(Hemodiafiltration,HDF)对终末期肾脏病合并顽固性高血压的透析患者血压节律、钙磷代谢的影响。方法:将62例终末期肾脏病合并顽固性高血压患者随机分为治疗组和对照组,对照组应用常规HD治疗,每周3次,每次4 h,治疗组低钠联合HDF治疗,每周1次,3个月后进行效果评价。比较两组治疗前后血压昼夜节律、钙磷代谢变化及不良反应的发生情况。结果:治疗后,治疗组24 h收缩压(systolic blood pressure,24h SBP)、24 h舒张压(diastolic blood pressure,24h DBP)、日间收缩压(day systolic blood pressure,dSBP)、日间舒张压(day diastolic blood pressure,dSBP)、夜间收缩压(night systolic blood pressure,nSBP)、夜间舒张压(night diastolic blood pressure,nSBP)均较治疗前明显下降,且明显低于对照组(P0.05);对照组除nSBP外,其余血压指标治疗前后比较差异均无统计学意义(P0.05)。治疗后,治疗组血Ca水平较治疗前明显升高,且显著高于对照组,而血P、PTH水平较治疗前明显降低,且均明显低于对照组(P0.05)。治疗组和对照组不良反应发生率分别为16.1%、12.9%,两组比较差异无统计学意义(P0.05)。结论:低钠HD联合HDF治疗终末期肾脏病合并顽固性高血压患者可有效改善钙磷代谢并促进血压节律恢复。     

Effects of Topical Bimatoprost 0.01% and Timolol 0.5% on Circadian IOP,Blood Pressure and Perfusion Pressure in Patients with Glaucoma or Ocular Hypertension: A Randomized,Double Masked,Placebo-Controlled Clinical Trial

PurposeTo compare the 24-hour (24h) effects on intraocular pressure (IOP) and cardiovascular parameters of timolol 0.5% and bimatoprost 0.01% in open angle glaucoma and ocular hypertensive subjects.MethodsIn this prospective, randomized, double masked, crossover, clinical trial, after washout from previous medications enrolled subjects underwent 24h IOP, blood pressure (BP) and heart rate (HR) measurements and were randomized to either topical bimatoprost 0.01% at night plus placebo in the morning or to timolol 0.5% bid. After 8 weeks of treatment a second 24h assessment of IOP, BP and HR was performed and then subjects switched to the opposite treatment for additional 8 weeks when a third 24h assessment was performed. The primary endpoint was the comparison of the mean 24h IOP after each treatment. Secondary endpoints included the comparisons of IOP at each timepoint of the 24h curve and the comparison of BP, HR, ocular perfusion pressure and tolerability.ResultsMean untreated 24h IOP was 20.3 mmHg (95%CI 19.0 to 21.6). Mean 24h IOP was significantly lower after 8 weeks of treatment with bimatoprost 0.01% than after 8 weeks of treatment with timolol 0.5% bid (15.7 vs 16.8 mmHg, p = 0.0003). Mean IOP during the day hours was significantly reduced from baseline by both drugs while mean IOP during the night hours was reduced by -2.3 mmHg (p = 0.0002) by bimatoprost 0.01% plus placebo and by -1.1 mmHg by timolol 0.5% bid (p = 0.06). Timolol 0.5% significantly reduced the mean 24h systolic BP from baseline, the diastolic BP during the day hours, the HR during the night hours, and the mean 24h systolic ocular perfusion pressure.ConclusionBoth Bimatoprost 0.01% and Timolol 0.5% are effective in reducing the mean 24h IOP from an untreated baseline but Bimatoprost 0.01% is more effective than timolol 0.5% throughout the 24h. Timolol 0.5% effect on IOP is reduced during the night hours and is associated with reduced BP, HR and ocular perfusion pressure.

Trial Registration

EU Clinical Trial Register and EudraCT# 2010-024272-26     

Treatment of Hypogonadism with Testosterone in Patients with Type 2 Diabetes Mellitus

ObjectiveTo investigate the effect of testosterone treatment on insulin resistance, glycemic control, and dyslipidemia in Asian Indian men with type 2 diabetes mellitus (T2DM) and hypogonadism.MethodsWe conducted a double-blind, placebo-controlled, crossover study in 22 men, 25 to 50 years old, with T2DM and hypogonadism. Patients were treated with intramuscularly administered testosterone (200 mg every 15 days) or placebo for 3 months in random order, followed by a washout period of 1 month before the alternative treatment phase. The primary outcomes were changes in fasting insulin sensitivity (as measured by homeostasis model assessment [HOMA] in those patients not receiving insulin), fasting blood glucose, and hemoglobin A1c. The secondary outcomes were changes in fasting lipids, blood pressure, body mass index, waist circumference, waist-to-hip ratio, and androgen deficiency symptoms. Statistical analysis was performed on the delta values, with the treatment effect of placebo compared with the effect of testosterone.ResultsTreatment with testosterone did not significantly influence insulin resistance measured by the HOMA index (mean treatment effect, 1.67 ± 4.29; confidence interval, -6.91 to 10.25; P > .05). Mean change in hemoglobin A1c (%) (-1.75 ± 5.35; -12.46 to 8.95) and fasting blood glucose (mg/dL) (20.20 ± 67.87; -115.54 to 155.94) also did not reach statistical significance. Testosterone treatment did not affect fasting lipids, blood pressure, and anthropometric determinations significantly.ConclusionIn this study, testosterone treatment showed a neutral effect on insulin resistance and glycemic control and failed to improve dyslipidemia, control blood pressure, or reduce visceral fat significantly in Asian Indian men with T2DM and hypogonadism. (Endocr Pract. 2010;16:570-576)     

Agonistic Autoantibodies to the Angiotensin II Type I Receptor Cause Pathophysiologic Characteristics of Preeclampsia

BackgroundPreeclampsia (PE), new-onset hypertension with proteinuria during pregnancy, is associated with increased reactive oxygen species, the vasoactive peptide endothelin-1 (ET-1), T and B lymphocytes, soluble antiangiogenic factors sFlt-1 and sEndoglin (sFlt-1 and sEng), and agonistic autoantibodies to the angiotensin II type I receptor (AT1-AA).ObjectivesOne important area of investigation for our laboratory was to determine what role AT1-AA plays in the pathophysiology associated with PE.MethodsTo achieve this goal, we examined the effect of AT1-AA suppression on hypertension in response to placental ischemia as well as the effect of AT1-AA on increased blood pressure, ET-1, reactive oxygen species, and sFlt-1 in normal pregnant rats (NP).ResultsWe demonstrated reductions in uterine perfusion pressure (RUPP) to be a stimulus for AT1-AA during pregnancy. We utilized the technique of B-cell depletion to suppress circulating AT1-AA in RUPP rats and found that AT1-AA suppression in RUPP rats was associated with lower blood pressure and ET-1 activation. To determine a role for AT1-AA to mediate hypertension during pregnancy, we infused purified rat AT1-AA (1:50) into NP rats, and analyzed blood pressure and soluble factors. We consistently found that AT1-AA infused rats had significantly increased AT1-AA and blood pressure above NP rats. This hypertension was associated with significantly increased ET-1 in renal cortices (11-fold) and placenta (4-fold), and there was an approximately 2- to 3-fold increase in placental oxidative stress. Furthermore, antiangiogenic factors sFlt-1 and sEng were significantly increased in the AT1-AA induced hypertensive group compared with the NP controls.ConclusionsCollectively, these data indicated an important role for AT1-AA stimulated in response to placental ischemia that caused hypertension during pregnancy.     

Effects of praeruptorin C on blood pressure and expression of phospholamban in spontaneously hypertensive rats

BackgroundThe traditional Chinese medicine Praeruptorin c (Pra-c) has many physiological and pharmacological effects, including antagonistic effects on blood pressure and calcium levels, maintenance of cellular calcium homeostasis, and improved cardiac systolic and diastolic function. It is potentially a novel and versatile drug for the treatment and prevention of cardiovascular diseases.ObjectiveTo explore the possible impact of Pra-c on blood pressure in SHR and its mechanism of action.Materials and methodsTwenty SHR were randomly divided into a Pra-c group [Pra-c was administered intragastrically, 20 mg kg⁻¹ d⁻¹, n = 10] or an untreated control group (n = 10), containing 10 age-matched SD rats. Each group of rats was followed for 8 weeks. Before and during the treatment, tail artery systolic blood pressure was measured using a tail-cuff every 2 weeks. After 8 weeks, the rats were sacrificed and RNA was extracted from homogenates of cardiac tissue. Tissue from the left ventricle was fixed, sectioned and H&E stained to assess possible changes in myocardial cell structure and morphology. Semi-quantitative RT-PCR was used to assess changes in phospholamban gene expression in treated and untreated rats.ResultsSHR treated with Pra-c for 8 weeks had a lower systolic pressure than untreated SHR (p < 0.05), two measures of cardiac damage, the heart mass index and left ventricle mass index (HMI and LVMI, respectively) were improved, and the level of PLB mRNA expression was lower in the untreated SHR group (p < 0.05).Discussion and conclusionWith continuous hypertension, SHR gradually formed or developed cardiac hypertrophy and fibrosis. Pra-c had a clear effect on blood pressure in SHR, and reversed SHR ventricular remodeling by upregulating the gene expression of sarcoplasmic reticulum PLB.     

手足温针灸联合步行阶梯训练对老年糖尿病周围神经病变患者步态异常、血流动力学和感觉及运动神经传导的影响

摘要 目的：观察手足温针灸联合步行阶梯训练对老年糖尿病周围神经病变（DPN）患者步态异常、血流动力学和感觉及运动神经传导的影响。方法：按照随机数字表法将上海市第六人民医院2020年3月~2022年1月期间收治的119例老年DPN患者分为对照组（n=59,步行阶梯训练）和研究组（n=60,手足温针灸联合步行阶梯训练）。对比两组疗效、步态异常、血流动力学、临床症状改善情况和感觉及运动神经传导变化情况。结果：研究组91.67%的临床总有效率高于对照组72.88%（P<0.05）。研究组干预后的密歇根糖尿病神经病变评分（MDNS）和多伦多临床评分系统（TCSS）评分低于对照组（P<0.05）。研究组干预后的腓总神经及胫神经的感觉神经传导速度（SNCV）、运动神经传导速度（MNCV）高于对照组（P<0.05）。研究组干预后的全血黏度、血浆比黏度、纤维蛋白原低于对照组（P<0.05）。研究组足底压力中心轨迹（COP）曲线异常、全足平衡性曲线异常、全足压力变化曲线异常例数少于对照组（P<0.05）。结论：手足温针灸联合步行阶梯训练可促进老年DPN患者步态异常、血流动力学和感觉及运动神经传导恢复,疗效较好。     

吉西他滨热化疗治疗肝癌的临床效果及对血清MGMT水平的影响

目的:探讨吉西他滨热化疗治疗肝癌的临床效果及对血清O6-甲基鸟嘌呤DNA甲基转移酶(O6-methylguanine-DNA methyltransferase,MGMT)水平的影响。方法:选取2014年2月-2017年4月在我院诊治的59例肝癌患者,根据治疗方法的方法不同分为观察组30例、对照组29例,对照组给予常规化疗,化疗观察3个周期;观察组在对照组化疗的基础上给予吉西他滨热灌注化疗,比较两组的临床疗效、不良反应的发生情况、生存情况及治疗前后血清MGMT表达的变化情况。结果:观察组患者的热灌注化疗均成功进行,治疗前后患者的体温、呼吸频率、心率、血压等对比无显著差异(P0.05)。治疗后,观察组总有效率是66.7%,显著高于对照组(31.0%)(P0.05)。两组治疗期间的毒性反应发生率间无显著差异(P0.05)。两组治疗后血清MGMT表达都较治疗前显著降低(P0.05),且观察组的血清MGMT表达明显比对照组低(P0.05)。随访至2017年11月30日,观察组的疾病进展时间(Time to Progression,TTP)、生存时间(overall survival,OS)分别为8.11±2.19个月和14.29±1.87个月,都显著高于对照组的6.22±1.82个月和11.48±2.19个月(P0.05)。结论:吉西他滨热化疗治疗肝癌可提高疗效,延长患者的生存时间,且不增加毒副反应,可能与其有效降低患者血清MGMT表达有关。