目的 探讨血红素氧合酶-1(HO-1)对脓毒症心肌损伤大鼠血浆中高迁移率族蛋白B-1(HMGB-1)变化的影响及其心肌保护机制.方法 采用盲肠结扎穿孔术(CLP)建立脓毒症大鼠模型.SPF级SD雄性大鼠128只,分为4组:假手术组、脓毒症组、钴原卟啉Ⅸ组(CoppⅨ组)、锌原卟啉Ⅸ组(ZnppⅨ组),每组32只.术后分别在0、6、12、24 h取全血检测血浆中肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTn I)、心型脂肪酸结合蛋白(H-FABP)及HMGB-1的表达;24 h除取全血检测上述指标外,留取心脏组织行苏木素-伊红(HE)染色,观察心肌损伤情况,提取心肌细胞总蛋白,Western Blot检测心肌细胞HMGB-1及HO-1蛋白的表达.结果 除假手术组外,各实验组HMGB-1水平随时间增加均升高,其中ZnppⅨ组升高最明显,与脓毒症组相比,差异有统计学意义(P＜0.05),与CoppⅨ组相比,差异亦有统计学意义(P＜0.01).光镜下假手术组细胞结构基本正常,CoppⅨ组细胞肿胀、胞核完整,脓毒症组及ZnppⅨ组细胞肿胀明显,核溶解坏死.Western Blot检测结果表明,ZnppⅨ组HMGB-1蛋白表达最高,HO-1蛋白表达最低,而CoppⅨ组H01蛋白表达最高,HMGB-1蛋白表达最低.结论 HO-1抑制脓毒症心肌损伤大鼠血浆中HMGB-1的表达,并可能通过抑制HMGB-1的表达而发挥心肌保护作用.

目的 探讨血红素加氧酶-1(HO-1)在脓毒症大鼠心肌损伤中的作用及其对血清高迁移率族蛋白B1(HMGB1)水平的影响.方法 选择128只SD大鼠,随机分为假手术组、脓毒症组、钴原卟啉(CoppⅨ)组、锌原卟啉(ZnppⅨ)组,每组32只.CoppⅨ组和ZnppⅨ组均于造模前24 h分别给予腹腔注射HO-1增强剂CoPPⅨ10 mg/kg、HO-1抑制剂ZnppⅨ10 mg/kg,假手术组和脓毒症组不给药.脓毒症组、CoppⅨ组、ZnppⅨ组均采用盲肠结扎穿孔(CLP)法建立脓毒症模型.假手术组无菌状态下开腹找出盲肠后再将其还纳腹腔,不做CLP术.各组均于造模后0、6、12、24 h时处死大鼠8只,开腹经腹主动脉取血,ELISA法检测各组血清心肌损伤指标包括肌酸激酶同工酶(CK-MB)、肌钙蛋白-I(cTnI)、B型脑钠肽(BNP)、心型脂肪酸结合蛋白(H-FABP),以及HMGB1、HO-1水平.采用Pearson相关系数法分析HMGB1与HO-1的相关性.结果 ①各组血清心肌损伤指标水平比较:脓毒症组6、12、24 h时血清CK-MB、cTnI、BNP、H-FABP水平均高于假手术组(P均<0.05).CoppⅨ组24 h血清CK-MB、cTnI、BNP水平均低于脓毒症组,ZnppⅨ组6、12、24 h时血清CK-MB、cTnI、BNP水平均高于脓毒症组(P均<0.05).Zn-ppⅨ组12、24 h时血清CK-MB、cTnI、BNP水平均高于CoppⅨ组,6、12、24 h时血清H-FABP均高于CoppⅨ组(P均<0.05).②各组血清HMGB1、HO-1水平比较:脓毒症组6、12、24 h时血清HMGB1及HO-1水平均高于假手术组(P均<0.05).6、12、24 h时,CoppⅨ组血清HMGB1水平均低于脓毒症组、HO-1水平均高于脓毒症组,ZnppⅨ组血清HMGB1水平均高于脓毒症组、HO-1水平均低于CoppⅨ组(P均<0.05).③HMGB1与HO-1的相关性:脓毒症组、CoppⅨ组、ZnppⅨ组血清HMGB1与HO-1水平均呈负相关(r分别为-0.342、-0.415、-0.437,P均<0.05).结论 HO-1对脓毒症大鼠的心肌具有保护作用,HO-1对心肌的保护作用可能与降低HMGB1水平有关.

帕金森病（PD）是一种与年龄相关的神经系统变性疾病，在老年患者神经系统变性疾病中居第二位〔1〕。我国现有 PD患者人数约200万，男性发病较女性多见。病理上主要表现为黑质多巴胺能神经元变性、缺失及黑质－纹状体通路的变性、神经元内路易小体的形成。 PD 的病因及发病机制十分复杂，至今仍未彻底明确，但可能与环境、遗传、年龄、氧化应激、线粒体功能缺陷和泛素－蛋白酶体功能异常等因素密切相关〔2〕。目前，有充分证据证明高血清总胆固醇（TC）增加中老年人患冠心病的风险，关于血清 TC 和神经系统变性疾病之间的联系仍存在争议。一些前瞻性研究发现高血清 TC 增加了患阿尔茨海默病（AD）的风险〔3〕，但血清 TC 和 PD 相关性存在争议。国外有部分学者对血脂与帕金森病相关性进行了研究，但未得出统一结论。本文分析 PD 与血清 TC 的相关性。

BACKGROUND: Angiogenesis in atherosclerotic plaque occurred on the basis of atherosclerotic lesions, and the new formed blood vessels promoted the development of angiogenesis. Soluble vascular endothelial growth factor receptor 1 (sFlt-1) gene transfection reduces neointimal formation after vascular injury in rabbits, also reduces early vascular inflammation and proliferation, and the formation of neointima lately. <br> OBJECTIVE: To observe the effects of highly expressed sFlt-1 on atherosclerotic plaque. <br> METHODS: A total of 48 male New Zealand rabbits were divided into four groups randomly: normal control group (n=8), sham operation group (n=8), bal oon injury+high lipid diet+pEGFP-N1 group (n=16) and bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group (n=16). Normal control group and sham operation group were supplied with normal diet. Bal oon injury+high lipid diet+pEGFP-N1 group and bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group were supplied with high lipid diet and injured by bal oon 2 weeks later. Bal oon injury+high lipid diet+pEGFP-N1 group was transfected with pEGFP-N1 and bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group was transfected with pEGFP-N1-sFlt-1. <br> RESULTS AND CONCLUSION: In the bal oon injury+high lipid diet+pEGFP-N1 group and bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group, blood lipid levels apparently increased. At 3 days after model establishment, sFlt-1 expression levels noticeably increased, and atherosclerotic plaque formed to different degrees. Plaque area, plaque perimeter, plaque maximum thickness and the number of positive-cel s within the plaque were significantly less in the bal oon injury+high lipid diet+pEGFP-N1-sFlt-1 group than in the bal oon injury+high lipid diet+pEGFP-N1 group. These results confirm that sFlt-1 gene may express effectively in iliac artery wal of rabbit, inhibited the formation of atherosclerotic plaque and delayed the development of atherosclerotic plaque.

下肢疼痛伴足跖徐动症（ PLMT）是一种少见的运动障碍性疾病，主要表现为肢体疼痛伴远端的重复但非节律性的不自主动作，狭义的概念为下肢及足跖受累，广义的概念包括上肢及身体其他部分受累。 PLMT由Spillane在1971年首次报道并命名［1－2］，目前其发病机制不明确。国内 PLMT 研究甚少，本文将对PLMT综述如下。

Objective The aim of the present study was to investigate the effect of esmolol on myocardial injury of senile sep-tic shock. Methods Thirty-six cases more than 60 years old of septic shock,whose rate is still greater than 100 beats/min after standardized treatment,were selected. According to heart basic diseases such as coronary heart disease or atrial fibrillation,they were randomly divided into three groups. Group A:without basic diseases such as coronary heart disease and atrial fibrillation group;Group B:history of coronary heart disease (CHD) and accept a beta blocker treatment group;Group C:previous have atrial fibrillation and long-term administration of beta blockers to control ventricular rate group. Esmolol Were given to intervene. Car-diac function was evaluated before and after administration of the drug within 2 hours. Results After administration of esmolol in-tervention and up to standard,on one hand,patients’APACHE-II scores and MODS scores decreased,including CK-MB,cTnI and BNP declining. On the other hand,central venous oxygen saturation improved and blood lactate decreased,urine volume increased. Compared with before administration,it was statistically significant (P<0.05);Cardiac ultrasound examination suggests that the ejec-tion fraction of group B and C instead of fell,fall but rose,in addition to group A. Group C increased significantly (P<0.01). Before and after treatment in patients with diastolic function did not change significantly (P>0.05). Conclusion Esmolol has an protective effect on myocardial injury of septic shock infections in the elderly,especially with heart foundation disease such as coronary heart disease and atrial fibrillation.

Objective To investigate the correlation between the continuous blood purification and middle-late early acute respiratory distress syndrome intervention's influence on the prognosis of patients. Methods CBP technology was applied to 67 patients with acute respiratory distress syndrome diagnosis were treated,enzyme-linked immunosorbent analysis test before and af-ter treatment 6,12,24,and 36 hours in plasma TNF alpha,beta,IL-6,IL-1 the concentration of IL-8,compare the two different times to intervention on the cure rate and mortality of patients with ARDS. Results Two groups of patients with ARDS after CBP treatment are decreased,serum levels of the inflammatory factors and drop is different in the different periods,the index fell to the lowest 36 hours after treatment,compared with before treatment,with significant difference (P<0.01). Early CBP treatment group cure rate than the middle-late CBP treatment group was obviously higher,significantly lower mortality rate,cure rate and mortality of comparison between the two groups,the difference was statistically significant(P<0.05). Conclusion CBP cytokines in plasma in patients with ARDS is exact and effective,if can early intervention is helpful to block the inflammatory response in time and im-prove the ARDS treatment success rate.

<正>帕金森病(PD)在老年患者神经系统变性疾病中居第二位〔1〕。全国每年新发患者数达10万以上,我国现有PD患者约200万。临床上以静止性震颤、肌肉强直、运动迟缓及姿势步态异常为主要表现〔1〕,还包括非运动症状和自主神经症状。病理上主要表现为黑质多巴胺能神经元变性、缺失及黑质-纹状体