Morphometric analysis of atrial natriuretic peptide-containing granules in atriocytes of rats with experimental congestive heart failure

The morphometric characteristics of atrial natriuretic peptide-containing granules were studied in atrial myoendocrine cells of rats with aorto-caval fistula, an experimental model of congestive heart failure. A total of 6680 granules of control and aorto-caval rats were analyzed by a computerized image analysis system that evaluated the number and sectioned surface area of granules and their subcellular location. Compared with control animals, rats with congestive heart failure displayed a slight increase in the number of peripheral granules, adjacent to the sarcolemma, but not centrally located in the Golgi areas. The mean sectioned surface area of granules in rats with congestive heart failure was about 50% of that in controls, both in the right and left atria. Rats with aortocaval fistula had a higher percent of small granules and lower percent of large granules compared with controls. The data demonstrate different morphometric characteristics in atrial natriuretic peptide-containing granules in atriocytes in rats with experimental congestive heart failure; this may reflect the enhanced synthesis and release of atrial natriuretic peptide in heart failure.     

Analysis of food stimulation of gastrin release in dogs by a panel of inhibitors

The release of gastrin into the serum of five conscious gastric fistula dogs after a meat meal was monitored for 2 hours. Neither the rate of increase in serum gastrin nor the 2 hour cumulative integrated gastrin response was changed by administration of small doses of somatostatin tetradecapeptide (0.5 microgram/kg.hr IV for 2 hr), 16-16 dimethyl prostaglandin E2 (0.25 microgram/kg.hr IV for 2 hr or 1 microgram/kg intragastrically), or bethanechol (20 micrograms/kg.hr IV for 2 hr). Acidification of the food in the antrum to pH 1.2 to 1.4 eliminated serum gastrin release in response to food. In control studies, serum gastrin levels were not altered by IV administration of saline for 2 hr with no food or when a plate of food was held just out of the dogs' reach (teasing). Food-stimulated gastrin release was contrasted with that stimulated by bombesin under identical laboratory conditions [17]. In each case, antral acidification, somatostatin, prostaglandin E2 and bethanechol affected bombesin-stimulated gastrin release differently from that stimulated by food. We conclude that food and bombesin release gastrin by different pathways.     

桡动脉-头静脉瘘成熟障碍原因分析及治疗的研究进展

桡动脉-头静脉瘘因其通畅率高、并发症少而被认为是血液透析血管通路的第一选择,但高达50%的内瘘因各种原因不能成熟,这主要是由于持续性地低血流量或穿刺困难导致无法进行充分的血液透析。常见的原因有流入道或流出道狭窄、吻合口狭窄、静脉位置过深及分支静脉的分流。此外,血栓形成是造成狭窄的一个常见原因。术前通过体格检查和超声检查评估血管条件选择合适的血管对于内瘘的成熟有着重要的意义。应针对引起成熟障碍的病因选择合适的治疗方法:术后普遍应用阿司匹林预防血栓形成进而减少狭窄的发生;外科手术有绕过损伤区域的优点但却创造一个新的吻合;近年来血管腔内技术因其微创的特点在大多数时候是第一选择。本文将对内瘘成熟障碍的定义、病因、诊断及治疗进行综述。     

应用奥曲肽预防胰十二指肠切除术后胰漏作用的研究

目的:预防性使用奥曲肽是否能减少胰十二指肠切除术后胰漏发生率存在着争议。本研究旨在研究奥曲肽在不同胰腺情况下预防胰十二指肠切除术后胰漏发生的作用。方法:本研究将"软胰腺"、"细胰管"作为术后胰漏发生的高危险因素,将184例胰十二指肠切除术病例分为4组:低危险/非奥曲肽组、低危险/奥曲肽组、高危险/非奥曲肽组、高危险/奥曲肽组。观察术后胰漏等术后并发症情况。结果:共发生术后胰漏35例(19%),其中高危险组胰漏发生率是低危险组2倍以上(27%versus 10%,P<0.01)。在胰漏发生低危险胰腺情况下,奥曲肽组与非奥曲肽组术后胰漏发生无显著差别;在胰漏发生高危险胰腺情况下,奥曲肽能显著降低术后胰漏发生率。结论:在胰十二指肠切除术围手术期应根据胰腺的具体情况选择性使用奥曲肽既能有效预防术后胰漏的发生,又能避免不必要的浪费。     

Co-culture of human fibroblasts,smooth muscle and endothelial cells promotes osteopontin induction in hypoxia

Arteriovenous fistulas (AVFs) are the preferred vascular access for haemodialysis of patients suffering from end-stage renal disease, a worldwide public health problem. However, they are prone to a high rate of failure due to neointimal hyperplasia and stenosis. This study aimed to determine if osteopontin (OPN) was induced in hypoxia and if OPN could be responsible for driving AVF failure. Identification of new factors that participate in remodelling of AVFs is a challenge. Three cell lines representing the cells of the three layers of the walls of arteries and veins, fibroblasts, smooth muscle cells and endothelial cells, were tested in mono- and co-culture in vitro for OPN expression and secretion in normoxia compared to hypoxia after silencing the hypoxia-inducible factors (HIF-1α, HIF-2α and HIF-1/2α) with siRNA or after treatment with an inhibitor of NF-kB. None of the cells in mono-culture showed OPN induction in hypoxia, whereas cells in co-culture secreted OPN in hypoxia. The changes in oxygenation that occur during AVF maturation up-regulate secretion of OPN through cell-cell interactions between the different cell layers that form AVF, and in turn, these promote endothelial cell proliferation and could participate in neointimal hyperplasia.     

Technical Aspects of the Mouse Aortocaval Fistula

Technical aspects of creating an arteriovenous fistula in the mouse are discussed. Under general anesthesia, an abdominal incision is made, and the aorta and inferior vena cava (IVC) are exposed. The proximal infrarenal aorta and the distal aorta are dissected for clamp placement and needle puncture, respectively. Special attention is paid to avoid dissection between the aorta and the IVC. After clamping the aorta, a 25 G needle is used to puncture both walls of the aorta into the IVC. The surrounding connective tissue is used for hemostatic compression. Successful creation of the AVF will show pulsatile arterial blood flow in the IVC. Further confirmation of successful AVF can be achieved by post-operative Doppler ultrasound.     

先天性支气管动脉-肺动脉瘘儿童咯血的介入治疗临床分析

目的:总结先天性支气管动脉-肺动脉瘘患儿的临床特点及诊治经验,探讨介入治疗支气管动脉-肺动脉瘘所致咯血的安全性及有效性。方法:回顾性分析我院自2009年7月至2017年6月收治的先天性支气管动脉-肺动脉瘘所致咯血患儿36例,行支气管动脉数字减影血管造影(DSA),选择300-700μm聚乙烯醇(PVA)微栓颗粒或微球颗粒行支气管动脉栓塞术治疗,评价疗效,患者在术后1个月、3个月、半年、1年门诊复查。结果:多层螺旋CT血管造影(MSCTA)显示支气管动脉-肺动脉瘘直接征象的诊出率为55.5%(20/36),16例为假阴性(44.4%),未发现假阳性病例;36例患者栓塞术后治疗即刻成功率为100%,复发率13.9%(5/36),复发时间出现于术后2-6个月,表现为再次咯血,但咯血量较初次封堵前减少,均行二次栓塞术。结论:介入治疗对于支气管动脉-肺动脉瘘所致咯血是一种创伤小、操作简便、疗效明确、并发症少的治疗方法。为进一步减少复发风险,患者术前应仔细进行MSCTA检查,行全面DSA下血管造影,根据患者病变血管情况选择合适的永久栓塞剂,运用恰当的栓塞技术。     

食管癌患者术前营养风险评估及与术后吻合口瘘和住院时间的关系研究

摘要 目的：评估食管癌患者术前营养风险及其影响因素,并分析其与术后吻合口瘘和住院时间的关系。方法：回顾性分析2017年1月至2020年12月在合肥市第二人民医院胸外科行手术治疗的105例食管癌患者的临床资料,患者术前均完善营养风险筛查表-2002（NRS-2002）对其营养风险的评估,根据评估结果分为营养风险组（≥3分,43例）和无营养风险组（＜3分,62例）,采用单因素及多因素Logistic回归分析食管癌患者术前营养风险的影响因素,比较不同术前营养风险状态患者术后吻合口瘘发生率以及住院时间的差异。结果：食管癌患者的术前营养风险较高,营养风险发生率为40.95%（43/105）。单因素分析结果显示,营养风险组年龄≥65岁、入院体质量指数＜18.5 kg/m²、术前接受过新辅助放化疗、过去1周膳食摄入不足、术前白蛋白＜35 g/L的患者比例高于无营养风险组（P＜0.05）。多因素Logistic回归分析结果显示,术前接受过新辅助放化疗、过去1周膳食摄入不足、术前白蛋白＜35 g/L是食管癌患者术前存在营养风险的危险因素（P＜0.05）。营养风险组术后胸腔吻合口瘘、颈部吻合口瘘发生率高于无营养风险组（P＜0.05）,住院时间长于无营养风险组（P＜0.05）。结论：术前新辅助放化疗、过去1周膳食摄入情况、术前白蛋白水平是食管癌患者术前营养风险的影响因素,术前营养风险会增加患者术后吻合口瘘发生风险,延长患者住院时间。     

Determinants of Intestinal Detoxication of Lipid Hydroperoxides

It has long been recognized that hydroperoxides are agents of cytotoxicity. However, in recent years, it is increasingly apparent that lipid hydroperoxide may play an important role in mediating cellular and molecular events in degenerative pathophysiological processes that lead to intestinal disorders, such as cancer. Yet, surprisingly, little is known of the intestinal disposition of peroxidized lipids and of the metabolic factors that determine mucosal peroxide elimination. The present paper summarizes the evidence for the pivotal role of reductant (GSH and NADPH) availability in intestinal peroxide detoxication. This information will provide important insights into the relationship between luminal lipid hydroperoxides and intestinal GSH redox homeostasis, and is pertinent to understanding how dietary oxidants like lipid peroxides, can impact intestinal integrity with implications for genesis of gut pathology.