目的 探讨免疫组化法检测Smad3蛋白(Smad3)、转化生长因子 β1(Transforming growth factor betal,TGF-β1)蛋白在肥厚型心肌病(Hypertrophic cardiomyopathy,HCM)大鼠体内的表达概况.方法 选择SPF级SD新生大鼠36只,随机分为4组,A组、B组(建模后3 d)、C组(建模后7 d)及D组(建模后14 d),各9只.B-D组建立HCM大鼠模型,A组仅分离腹主联率接扎,各组颈部脱白前检测左心室重量指数,处死后,分别采用苏木精HE检测病理,免疫组化/印迹及PCR检测Smad3、TGF-β1表达.结果 建模后3 d、7 d及14 d的B～D组大鼠直请LVMI水平均高于A组,建模14d后LVMI水平达到峰值;A组心肌组织整齐,纹理清晰,B～D组心肌组织逐渐出现水肿坏死,心肌纤维扩张及肌丝溶解,D组心肌组织空泡变性,细胞核国缩严重,大量炎症浸润.B组～D组大鼠心肌组织中TGF BI/Smad3阳性表达均高于A组,各组相比差异明显(P<0.001):B组～D组大鼠心肌组织中TCF-B1/Smad3蛋白相对表达均高于A组,各组相比差异明显(P<0001):B组～D组大鼠心肌组织中TGF-Bl/Sad3mRNA水平高于A组,各组相比差异明显(P<0.001).结论 TGF-B1/Smad3能够诱导心肌组织坏死及水肿,随着病情的加重TGF-B1Sma3水随之增加,说明TGF-B1Smd3参与HCM病理过程.

Objective To investigate the inhibitory effect and mechanism of sophoridine(Sop) on cell injury caused by hypoxia in rat myocardial cell line H9c2. Methods H9c2 cells were exposed to 1% O2 and cultured with different concentrations (1, 4 and 16 mmol/L) of Sop for 48 h. Cell viability was measured by MTT assay. The release level of LDH and the content of MDA were determined by the kit methods. Cell apoptosis was detected by flow cytometry. The protein expression of cleaved-caspase-3, p-PI3K and p-AKT was detected by Western blot. Results Sop alleviated the cell viability, LDH release, MDA content and hypoxia-induced apoptosis of H9c2 cells in a concentration-dependent manner (P＜0.05, P＜0.01, P＜0.001). Sop decreased the cleaved-caspase-3 expression and increased the ratio of p-PI3K/PI3K and p-AKT/AKT in a concentration-dependent manner (P＜0.05, P＜0.01, P＜0.001). Conclusions Sop reduces hypoxia-induced cell injury and has a protective effect in vitro model of H9c2 cells, the potential mechanism is enhancing the stimulation activity of PI3K/AKT signal.

目的:观察缬沙坦联合氨氯地平治疗高血压肾病的疗效.方法:选取南阳市中心医院2018年10月至2019年10月收治的72例高血压肾病患者作为研究对象,按照双色球随机分组法将患者分为对照组(36例,单一缬沙坦治疗)与观察组(36例,缬沙坦联合氨氯地平治疗),比较两组患者的治疗效果.结果:观察组患者持续治疗3个疗程的血压以及尿素氮、肌酐、24 h尿蛋白等相关肾功能生化检测结果均低于对照组,差异具有统计学意义(P＜0.05).两组患者治疗期间不良反应发生率比较,差异无统计学意义(P＞0.05).结论:高血压肾病患者缬沙坦联合氨氯地平治疗效果明显优于单一缬沙坦治疗,且不会增加不良反应发生率,安全性相对较高.

目的:研究稳定型心绞痛开展富马酸比索洛尔治疗的效果.方法:选择64例稳定型心绞痛患者,观察组予以富马酸比索洛尔治疗+心内科常规药物治疗,对照组予以心内科常规药物治疗.结果:明显改善了观察组治疗总有效率、不良反应情况,P＜0.05.结论:稳定型心绞痛开展富马酸比索洛尔治疗,效果较为理想.

目的 探讨冠心病患者血清氧化型低密度脂蛋白(ox-LDL),同型半胱氨酸(Hcy)和尿酸(UA)水平与左心结构的关系.方法 选取2016年1月-2018年1月我院收治120例冠心病患者作为研究组,同时选取同期我院120例健康体检者作为对照组,比较两组ox-LDL、Hcy、UA水平变化,分析冠心病患者ox-LDL、Hcy、UA水平与左心结构的关系.结果 研究组患者ox-LDL、Hcy、UA水平高于对照组,差异有统计学意义(P<0.05).研究组患者LVEDd、LVEDv、LVESd、LVESv水平高于对照组,差异有统计学意义(P<0.05),LVEF水平低于对照组,差异有统计学意义(P<0.05).研究组患者的ox-LDL、Hcy、UA水平与LVEDd、LVEDv、LVESd、LVESv水平均呈正相关系(P<0.05),ox-LDL、Hcy、UA与LVEF呈负相关系(P<0.05).结论 冠心病患者ox-LDL、Hcy、UA水平升高,且与患者左心结构、功能指标相关.

Objective:To investigate the characteristics of severe adverse drug reactions(ADRs)so as to pro-vide a reference for safe drug application in clinic.Methods:The severe ADRs reported from October 1,2005 to October 1,2015 in a hospital were analyzed.Result:A total of 97 cases of serious ADRs were collected,most of which(84 cases,86.60%)occurred in children at ages of 0 ~3 years,and were mainly caused by traditional Chinese medicine injections(25 cases,25.77%),vitamins(20 cases,20.62%)and antibacterial drugs(16 cas-es,16.49%). The clinical manifestations of ADRs included systemic damage(38 cases,26.95%)as well as damages in circulatory system(29 cases,20.57%)and respiratory system(25 cases,17.73%),most of which were improved after symptomatic treatment.Conclusion:The monitoring on ADRs caused by antibiotics and tradi-tional Chinese medicine injection should be further strengthened,and the safety of water-soluble and fat-soluble vi-tamins for injection should be re-evaluated to ensure the safety of medication in children.

OBJECTIVE:To observe the therapeutic efficacy and safety of sildenafil combined with beraprost in the treatment of congenital heart disease complicating with pulmonary artery hypertension. METHODS:62 eligible patients were randomly divided into group A, B, C. They were given sildenafil, beraprost , combined therapy of sildenafil and beraprost respectively for 6 months. The changes of 6MWD, mPAP and PVR in 3 groups were observed before and after administration, and adverse drug reactions were recorded. RESULTS:6MWD in group C increased significantly, compared with group A and B (P0.05). The levels of mPAP and PVR in group A and C decreased significantly, compared with before treatment (P0.05), those of group C decreased more significantly(P0.05);there was no significant change in group B. There was no significant difference in adverse drug reaction and no severe adverse drug reaction was found in each group. CONCLUSION: Combination of sildenafil and beraprost is more effective than them alone in the treatment of congenital heart disease complicating with pulmonary artery hypertension. And the drug combination is safe and worthy of recommending.

目的 探讨培哚普利对阵发性心房颤动患者窦性心律维持作用.方法 将46例阵发性心房颤动患者随机分为两组,两组患者除行病因治疗外,治疗组给与胺碘酮和培哚普利治疗,对照组给与胺碘酮治疗.随访6个月,观察两组患者心房颤动的复发率和治疗前后最大P波时限(Pmax )和P波离散度(Pd)的变化.结果 治疗组心房颤动的复发率明显减少,复发3例(13.04%),对照组复发10例(43.47%),两组比较差异有显著性(P<0.05).治疗组治疗前后Pmax 和Pd的变化明显(P<0.05),对照组无明显变化(P>0.05);治疗后组间比较Pmax和Pd变化明显(P<0.05).结论 培哚普利能降低阵发性心房颤动的复发率,缩短Pmax 和Pd,有预防心房颤动复发作用.

目的探求心房颤动(AF)的有效药物治疗方法。方法将84例AF患者随机分成治疗组和对照组各42例,治疗组采用胺碘酮、卡托普利和螺内酯联合治疗,对照组单用胺碘酮口服,观察是否转复窦性心律、心室率及不良反应并判断疗效。结果治疗组总有效率达90%,对照组总有效率为64%,2组比较有显著性差异(2=6.80,P<0.05)。结论联合用药治疗AF的疗效优于单一的胺碘酮口服。