1 临床资料 患者男性,44 岁,身高 170 cm,体重 68 kg.面颈部、上肢、胸部淤血水肿伴胸闷气短 10 d,以"上腔静脉综合征 "收住我院心外科.患者既往体健.阳性体征:面颈部、上肢、胸部淤血水肿,双肺呼吸动度减弱.影像学检查:头颅 + 胸部 +腹部 CT 检查提示:(1)双侧额叶对称性密度减低;(2)左、右头臂静脉及左侧锁骨下静脉管腔可见狭窄改变,多发栓子形成.心脏多普勒彩色超声检查提示(图 1),上腔静脉内探及低回声填充,未探及血流信号,上腔静脉血栓形成,心内结构未见异常,心功能正常,肺动脉压正常范围,二尖瓣轻度反流.

OBJECTIVE To study the effects of astragalus polysaccharide (APS) on Myocardial Ischemia Reperfusion Injury in Juvenile mice.METHODS 60 1-week-old male SD rats were rando mLy divided into 5 groups:sham (S group),ischemia-reperfusion (I/R group),APS (40 mg·kg-1),SB203580 (5 mg·kg-1),APS+ SB203580 (APS 40 mg·kg-1 + SB203580 5 mg·kg-1).After 20 days administered,the left anterior descending coronary artery was ligated for 60 minutes,then restore blood flow for 120 minutes.And then the mice were decapitated after sampling orbital blood,ELISA and Western-blot were used to measure the expression of tumor necrosis factor TNF-α,nuclear transcription factor NF-κB,mitogen-activated protein kinase p38MAPK and phosphorylated mitogen-activated protein kinase protein expression pho-p38MAPK in peripheral blood and myocardial tissues.RESULTS In the peripheral blood and myocardial tissues,compared with S group,the expression of TNF-α,NF-κB,p-p38MAPK in I/R group,APS group,SB group,APS and APS+ SB group were significantly higher (P＜0.05);the expression of TNF-α,NF-κB,p-p38MAPK in APS group,SB group,APS + SB group were significantly lower (P＜0.05),compared with I/R group.the inhibition effects of APS + SB group on NF-κB、TNF-α and p-p38 protein expression were significantly stronger than the APS group inhibition (P ＜ 0.05).CONCLUSION APS and p38MAPK inhibitor (SB203580) were able to improve inflammation response APSter myocardial ischemia-reperfusion injury in juvenile mice.the APS and combined with SB203580 significantly inhibited expression of TNF-α,NF-κB and p38MAPK signaling pathway,and has synergistic inhibition effect on myocardial ischemia-reperfusion injury.

目的 分析兰州市2010-2014年出生缺陷的发生率及发生顺位,了解出生缺陷发生的影响因素.方法 收集兰州市2009年10月1日-2014年9月30日所有孕满28周至产后7天的围产儿(出生或引产)资料,分析出生缺陷发生现况.结果 兰州市2010-2014年出生缺陷的发生率分别为82.61/万、106.74/万、129.98/万、111.91/万和138.25/万;兰州市围产儿中唇腭裂、先天性心脏病、多发缺陷的发生率及顺位,2010-2014年均处在前3位.结论 兰州市2010-2014年出生缺陷的发生率总体呈上升趋势,其中先天性心脏病的发生率总体呈上升趋势,神经管畸形的发生率总体呈下降趋势.应重点加强对唇腭裂、先天性心脏病的预防.

目的 探讨延胡索总生物碱对异丙肾上腺素(ISO)诱导的心肌梗死大鼠损伤心肌的保护作用.方法 SD大鼠60只,随机分为四组(每组15只),A组大鼠采用ISO诱导心肌梗死,并使用1.0 mg/kg延胡索总生物碱预处理.B组大鼠采用ISO诱导心肌梗死,并使用2.0 mg/kg延胡索总生物碱预处理.C组大鼠仅用ISO诱导心肌梗死.对照组大鼠不接受ISO和延胡索总生物碱处理.检测各组大鼠血流动力学参数和左心室功能参数.采集各组大鼠血浆及心肌组织标本,检测心肌组织中的氧化应激指标变化及凋亡相关蛋白的表达变化.检测血浆标本中心肌损伤标志物的水平.光学显微镜下观察各组大鼠心肌损伤情况.结果 与C组大鼠相比,延胡索总生物碱预处理可以有效抑制ISO引起的收缩动脉压、舒张动脉压及平均动脉压的降低,同时能够缓解ISO引起的心率降低(P均＜0.05).A组和B组大鼠的左心室最大收缩压变化速率及左心室最大舒张压变化速率均高于C组,左心室舒张末压均低于C组,上述差异具有统计学意义(P均＜0.05).与C组大鼠相比,A组和B组大鼠的丙二醛水平降低,谷胱甘肽、超氧化物歧化酶、过氧化氢酶及谷胱甘肽过氧化物酶的水平有所回升(P均＜0.05).A组和B组大鼠血浆中的心肌损伤指标肌酸激酶-MB和乳酸脱氢酶水平明显低于C组(P均＜0.05).光镜下对各组心肌组织的形态学检查可见,A组和B组大鼠心肌组织的坏死、炎性细胞浸润及心肌细胞水肿情况轻于C组.Western blot分析可见,A组和B组大鼠心肌组织的抗凋亡蛋白Bcl-2表达量高于C组,而促凋亡蛋白Bax低于C组.结论 延胡索总生物碱可减轻ISO诱导心肌梗死大鼠的氧化应激,稳定血流动力学参数,保护心功能,减轻心肌损伤和凋亡.

Objective To observe the protective and anti -arrhythmic effects of Resveratrol ( Res ) on isoproterenol ( ISO ) -induced myocardial infarction in rats.Methods The 30 healthy male SD rats were randomly divided into normal group , model group and experimental group , model group and the experimental group were injected subcutaneously large dose ISO (20 mg· kg -1 ) to establish an animal model of myocardial infarc-tion.The change of electrocardiogram (ECG) was observed.The levels of lactate dehydrogenase(LDH), creatine kinase isoenzyme (CK-MB) in blood plasma , the activities of superoxide dismutase ( SOD ) , and the content of malondialdehyde ( MDA) in mycardial tissue were measured.The expressions of connexin 43 ( Cx43 ) in myocardium were detected by immunohistochemistry method and was semi -quantitatively analyzed.Results Compared with the model group , Resveratrol could fight against ST-segment elevation in myocardial infarction of rats ( P<0.01 ).The serum LDH content were ( 1462.42 ±30.02 ) , ( 2976.48 ±159.29 ) ,&nbsp;(2078.64 ±135.68 ) in normal group, model group and experimental group , respectively.It was showed that myocar-dial infarction rats LDH increased obviously after resveratrol intervention.The contents of the CK -MB and MDA also show the corresponding ( P<0.01 ).And SOD activity in myocardial tissue and Cx 43 AOD value , for normal rats were (148.15 ±4.76) and (0.32 ±0.01), for model rats were (99.48 ±8.66) and (0.27 ±0.01), for experimental rats were ( 123.31 ±3.14 ) and ( 0.31 ±0.01 ) after resveratrol intervention , the differenc is significantly reduce distribu-tion disorders compared with model group ( P<0.01 ).Conclusion Resveratrol has a protective effect on acute myo-cardial infarction induced by isoproterenol in rats , has a reversal effect on the expession reduced and distribution disordered of Cx43 ,has anti-arrhythmic effect.

目的 制备艰难梭菌菌体特异性鸡卵黄抗体,探讨其对艰难梭菌感染小鼠的治疗作用.方法 建立艰难梭菌相关腹泻(CDAD)小鼠模型,将30只CDAD小鼠随机分为5组,每组6只,以11.86 mg/mL、1.186 mg/mL、0.1186 mg/mL艰难梭菌菌体特异性IgY灌胃,设立空白对照组及阴性对照组,1 d/次,0.5mL/只,连续3d.末次治疗24 h后处死小鼠,取盲肠组织中段制作病理切片;其余盲肠组织进行DAO、D-乳酸和TNF-α含量测定;测定回肠组织含水率.结果 阴性对照组和空白对照组小鼠盲肠黏膜脱落伴大量炎细胞浸润;高IgY组小鼠盲肠黏膜完整,未见炎性细胞浸润;中IgY组小鼠盲肠黏膜少量炎细胞浸润;低IgY组小鼠盲肠黏膜上皮细胞脱落,少量炎细胞浸润.高IgY组小鼠盲肠DAO含量均显著高于空白对照组和阴性对照组(P＜0.01);中IgY组小鼠DAO含量高于阴性对照组(P＜0.05);中、高IgY组小鼠TNF-α含量均低于低IgY组、空白对照组和阴性对照组(P＜0.05).结论 艰难梭菌菌体特异性IgY对艰难梭菌感染小鼠具有治疗作用.

目的：比较HTK液与STH液在婴幼儿心脏手术心肌保护的效果，为优化心肌保护策略提供理论依据。