大鼠心肌梗死动物模型的制备

目的建立一种稳定可重复的大鼠急性心肌梗死动物模型。方法SD大鼠经口气管插管,呼吸机辅助呼吸,开胸结扎冠脉左前降支。术后28 d行心脏超声,血流动力学及组织病理学检查。结果大鼠术后存活率60%;手术组LVEF较假手术组显著降低（P〈0.01）;与假手术组比,手术组的LVSP明显下降（P〈0.05）,±dp/dt显著降低（P〈0.01）,而LVEDP明显升高（P〈0.01）;病理组织学检查可见瘢痕形成,纤维组织增生。结论本文建立心肌梗死动物模型的方法操作简便、重复性好。     

A lack of association between adiponectin polymorphisms and coronary artery disease in a Chinese population

We investigated the association between two single nucleotide polymorphisms (SNPs) in the adiponectin gene (rs822395 and rs266729) and coronary artery disease (CAD) in a case-control study of 198 unrelated Chinese CAD patients (with ≥ 70% coronary stenosis or previous myocardial infarction) and 237 non-CAD controls. The ligase reaction was used to detect SNPs rs822395 and rs266729, and the allelic association of these SNPs with the occurrence and severity of CAD was assessed. There were no significant differences in the genotypic or allelic frequencies of the two SNPs between control and CAD individuals. In addition, there was no association between the two SNPs and the severity of CAD based on the number of diseased vessels. The frequencies of alleles C and G at rs266729 differed significantly between females in the CAD and control groups, but not between males. Female carriers of allele G at rs266729 had a higher risk of CAD compared with allele C carriers (OR = 1.30, 95% CI: 1.09-2.64, p = 0.02). These results indicate a gender-specific effect of the adiponectin gene rs266729 variant in modulating the risk of CAD in women.     

Arterial end-to-side grafting in coronary artery bypass grafting: the Tector procedure

Background. The current treatment of choice in patients with three-vessel coronary disease is coronary artery bypass grafting. The use of the left internal mammary artery in bypass grafting has shown superior long-term outcomes compared with venous grafting. In our study we assess the safety and feasibility of all-arterial coronary artery bypass graft surgery using the procedure as described by Tector et al. in 2001.Methods. Between June 2001 and February 2007, we studied 133 patients eligible for non-emergency surgical revascularisation. Primary endpoints were death or re-infarction within a 30-day period. Secondary endpoints were the need for emergency coronary surgery, angioplasty and mediastinitis. Long-term follow-up had a mean duration of 33 months postoperatively.Results. All 133 patients were successfully revascularised, 98% with the off-pump technique. In 93% of the patients (n=124) full arterial grafting was achieved using both internal mammary arteries. Thirty-day mortality was 1.5% (n=2), ten re-thoracotomies were performed, one myocardial infarction and one case of mediastinitis were reported. In the next four years six additional patients died. Most of these deaths were due to non-cardiovascular causes. Two patients required angioplasty because of distal bypass graft failure and one for new native coronary artery disease. Conclusion. All-arterial bypass grafting using both internal mammary arteries with the technique as described by Tector is safe and feasible without excess deep sternal wound infections. Late major adverse cardiac events are rare and due to distal graft dysfunction, which can be treated by percutaneous coronary intervention. (Neth Heart J 2010;18:7-11.)     

8,9-Epoxyeicosatrienoic acid analog protects pulmonary artery smooth muscle cells from apoptosis via ROCK pathway

Epoxyeicosatrienoic acids (EETs), metabolites of arachidonic acid (AA) catalyzed by cytochrome P450 (CYP), have many essential biologic roles in the cardiovascular system including inhibition of apoptosis in cardiomyocytes. In the present study, we tested the potential of 8,9-EET and derivatives to protect pulmonary artery smooth muscle cells (PASMCs) from starvation induced apoptosis. We found 8,9-epoxy-eicos-11(Z)-enoic acid (8,9-EET analog (214)), but not 8,9-EET, increased cell viability, decreased activation of caspase-3 and caspase-9, and decreased TUNEL-positive cells or nuclear condensation induced by serum deprivation (SD) in PASMCs. These effects were reversed after blocking the Rho-kinase (ROCK) pathway with Y-27632 or HA-1077. Therefore, 8,9-EET analog (214) protects PASMC from serum deprivation-induced apoptosis, mediated at least in part via the ROCK pathway. Serum deprivation of PASMCs resulted in mitochondrial membrane depolarization, decreased expression of Bcl-2 and enhanced expression of Bax, all effects were reversed by 8,9-EET analog (214) in a ROCK dependent manner. Because 8,9-EET and not the 8,9-EET analog (214) protects pulmonary artery endothelial cells (PAECs), these observations suggest the potential to differentially promote apoptosis or survival with 8,9-EET or analogs in pulmonary arteries.     

Signal transduction through Ras-GTPase and Ca2+/ calmodulin-dependent protein kinase II contributes to development of diabetes-induced renal vascular dysfunction

This study examined the role of Ca2+/calmodulin-dependent protein kinase II (CaMKII) and Ras-GTPase in the development of abnormal reactivity to vasoactive agents in the renal artery of diabetic rats. The vasoconstrictor response induced by norepinephrine (NE), endothelin-1 (ET-1) or angiotensin II (Ang II) was significantly increased whereas vasodilator response to carbachol, histamine or sodium nitroprusside (SNP) was not altered in the renal artery segments of the streptozotocin (STZ)-diabetic rats. Chronic intraperitoneal administration of KN-93 (5 mg/kg/ alt diem), an inhibitor of CaMKII or FPTIII (1.5 mg/kg/ alt diem), an inhibitor of Ras-GTPase, produced significant normalization of the altered agonist-induced vasoconstrictor responses without affecting blood glucose levels. All the inhibitors were administered for four weeks starting from day one of diabetes induction. Inhibition of Ras-GTPase or CaMKII did not affect the agonist-induced vasoconstrictor and vasodilator responses in the non-diabetic control animals. These data suggest that inhibition of signal transduction involving CaMKII and Ras-GTPase can prevent development of diabetes-induced abnormal vascular reactivity in the renal artery.     

纤溶酶与盐酸丁咯地尔联合治疗椎-基底动脉供血不足的临床研究

目的观察纤溶酶与盐酸丁咯地尔联合治疗椎-基底动脉供血不足的临床疗效。方法治疗组50例应用纤溶酶200U,每天1次,连续用10天;同时应用盐酸丁咯地尔100mg,每天1次,连续应用15天。对照组48例应用盐酸丁咯地尔100mg,每天1次,连续15天。观察治疗前后血液流变学指标变化并评价其疗效。结果治疗组总有效率90.0%,对照组总有效率62.5%,两组差异显著(P<0.01)。治疗组在改善全血粘度、血浆粘度、增加红细胞变形指数、降低纤维蛋白原方面优于对照组(P<0.05);治疗组患者的凝血酶原时间延长(P<0.05),但不影响出凝血时间(P>0.05)。结论纤溶酶与丁咯地尔联合应用比单纯应用丁咯地尔治疗椎-基底动脉供血不足的疗效显著。     

亚急性轻度缺氧增加组胺刺激的肺动脉内皮细胞钙振荡频率

钙振荡 (calcium oscillation) 能以频率解码的形式调节基因转录,钙振荡的频率可反应基因转录的水平 . 为探索持续缺氧是强化还是钝化肺动脉内皮细胞对组胺的反应,研究了 24 h 亚急性轻度缺氧对组胺刺激的肺动脉内皮细胞钙振荡频率的影响,并探索了其机制 . 结果是： a. 24 h 亚急性轻度缺氧可显著增加组胺刺激的肺动脉内皮细胞钙振荡频率; b.NADPH 氧化酶抑制剂, diphenylene iodonium chloride (DPI , 10 μmol/L) 消除了组胺刺激的常氧和缺氧后肺动脉内皮细胞钙振荡; c. 黄嘌呤氧化酶抑制剂,别嘌呤醇 (oxypurinol , 100 μmol/L) 能显著降低组胺刺激的缺氧后肺动脉内皮细胞升高的钙振荡频率,但降低后的钙振荡频率仍高于常氧组,别嘌呤醇对组胺刺激的常氧组肺动脉内皮细胞钙振荡频率无显著影响 . 以上结果表明,在持续缺氧相关的肺疾患中,肺动脉内皮细胞对组胺反应的敏感性增加 . NADPH 氧化酶在组胺刺激的钙振荡的发生中发挥重要作用;黄嘌呤氧化酶的激活是缺氧引起组胺刺激的钙振荡频率增加的重要原因 .     

手掌分区与指掌侧总神经和指掌侧总动脉

目的：为研究手掌血管、神经损伤修复重建提供解剖学基础。方法：手掌借5条横平行线和4条纵平行线分为20区,解剖并观察指掌侧总神经和指掌侧总动脉在手掌的分布及其伴行关系。结果：第一、二指掌侧神经起始处位于7区外上象限,第三指掌侧总神经、小指尺掌侧神经起始处位于4区内下象限。第一、二、三指掌侧总动脉起始处位于7、8区近C线处。小指尺掌侧动脉起始处位于8区内下象限。第一、二指掌侧总神经在7区被掌浅弓骑跨,分弓上、下两段。弓上、下段,分别在13、14区D线处发出指掌侧固有神经。小指尺掌侧神经、第三指掌侧总神经起始处位于同名动脉的近侧,其行程在9、15、20区位于同名动脉的尺侧。第一、二指掌侧总动脉分别在18、19区距E线0．8-1．0cm处发出相应的指掌侧固有动脉。第一、二、三指掌侧总神经及其发出的指掌侧固有神经与同名的指掌侧总动脉的伴行关系有四型：H1、H2、O、V型。结论：指掌侧总神经与指掌侧总动脉在手掌的一定区域内有按规律分布的特点,有助于手掌损伤离断手术修复过程中指掌侧总神经与指掌侧总动脉的寻找和吻合,以及手掌神经阻滞麻醉的精确定位。