【摘要】 目的 探讨急性肾缺氧复氧损伤过程中氧化侵袭与肾细胞凋亡在肾损伤发生机制中的作用。 方法 20只雄性新西兰大白兔随机分成两组，每组10只。正常对照组（A组）：吸入空气6 h。单纯缺氧复氧组（B组）:经自制面罩吸入8% O2 3 h，缺氧结束后吸入空气复氧3 h，制成全身缺氧复氧模型。复氧结束后立即处死动物，取出肾脏组织，一份行HE染色，观察组织病理学改变，一份供半胱氨酸蛋白酶3（caspase-3）检测，一份供检测丙二醛（MDA）、超氧化物歧化酶（SOD）。 结果 病理学检查结果显示，A组肾脏组织结构基本正常，未见病理性改变，肾脏组织中极少的caspase-3阳性细胞表达。B组:肾小管上皮细胞肿胀，空泡变性；可见少量坏死，管腔明显扩张；caspase阳性蛋白表达指数（29.3±5.7）%。B组和A组MDA分别为（28.05±1.92）、（7.88±1.69）nmol/g；SOD分别为（218±18.41）、（372±13.14）U/g，两组比较，均有统计学意义（Plt;0.05）。 结论 兔肾脏缺氧复氧损伤与氧化侵袭与细胞凋亡密切相关。【Abstract】 Objective To investigate the effect of oxidative invasion and cellular apoptosis on the mechanism of kidney injury during the process of acute renal hypoxic-reoxygenation injury. Methods Twenty male white New Zealand rabbits were selected and randomly divided into two groups with 10 rabbits in each. The rabbits in normal control group inhaled air for 6 hours while the ones in hypoxic/reoxygenation (H/R) group breathing in air for 3 hours inhaled 8% O2 for 3 hours after. After the H/R mode was set up, the rabbits were executed, and the kidney tissues were removed in which the caspase-3 protein expression was assessed by immunohistochemical method. Superoxide dismutase (SOD) activity and malonical aldehyde (MDA) were also detected. Results The results of pathological examination showed that the structure of renal tissues was normal with little expression of caspase-3; while swelling of renal tubular epithelial cells, vacuolar degeneration, little necrosis, dilated vascular lacuna were found in H/R group. The positive expression of caspase-3 was (29.3±5.7)% in H/R group. The contents of MDA were (28.05±1.92) and (7.88±1.69) nmol/g and SOD were (218±18.41) and (372±13.14) U/g in H/R and control group, respectively; the differences between the two groups were significant (Plt;0.05). Conclusion The acute renal hypoxic/reoxygenation injury has a correlation with oxidative invasion and cellular apoptosis.
The traditional obstetric neuraxial anesthesia has no visual technical support. The success rate is closely related to the experience of the anesthesiologist, so there is a certain failure rate. With the widespread use of high-resolution portable ultrasound machines in recent years, a large number of clinical studies have upheld the feasibility and effectiveness of ultrasound in neuraxial anesthesia. The application of ultrasound in obstetric neuraxial anesthesia has obvious advantages compared with traditional methods of puncture. Ultrasound can accurately locate the intervertebral space, reduce the number of punctures, enhance the success rate of puncture, enhance the quality of obstetric anesthesia, and increase patients' satisfaction and comfort. This review shows the advantages and limitations of ultrasound in obstetric neuraxial anesthesia.
The necessity and methods of systematic review or Meta-analysis of observational studies were introduced. The difference between the systematic review or Meta-analysis of observational studies and randomized controlled trials was also described.
Objective To investigate the curve correlation between ventilation pressure and tidal volume in assisted mechanical ventilation with facemask during anesthesia induction. Methods Between January and August 2015, 120 patients, American Society of Anesthesiology Ⅰ-Ⅱ, undergoing selective gynecological surgery were randomly divided into four groups: groups P5, P10, P15 and P20, with 30 patients in each group. Mask ventilation pressure for the four groups were respectively 5, 10, 15 and 20 cm H2O (1 cm H2O=0.098 kPa). Patients were ventilated by preset ventilation pressure and frequency based on different groups after loss of consciousness. Mean ventilation volume (mean value of three tidal volumes) and end-tidal carbon dioxide pressure (PetCO2) were recorded for analysis. Results There was no significant difference among the four groups in patient’s general condition (P>0.05). The tidal volume of assisted mechanical ventilation increased with ventilation pressure degrees, and the differences among the four groups were significant (P<0.05). After curve regression analysis, tidal volume and ventilation pressure showed a positive linear correlation when ventilation pressure was set at 5-20 cm H2O, and the correlation equation was: tidal volume = 33.612×ventilation pressure-53.155. PetCO2 in P5 group was lower than those in the other three groups (P<0.05), while there were no significant differences among groups P10, P15 and P20 (P>0.05). Conclusion When ventilation pressure is set at 5-20 cm H2O in assisted mechanical ventilation with facemask during anesthesia induction, tidal volume and ventilation pressure show a positive linear correlation.
ObjectivesTo systematically review the association between the variants of HNF1B gene and the risk of prostate cancer.MethodsPubMed, EMbase, The Cochrane Library, CNKI, CBM and WanFang Data databases were electronically searched to collect case-control studies on the association between the variants of HNF1B gene and risk of prostate cancer from inception to December, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 14.0 software.ResultsA total of 15 case-control studies involving 30 532 patients and 38 832 controls were included. The results of meta-analysis showed that: there was a strong significant association between rs4430796 variants (Gvs.A: OR=0.802, 95%CI 0.784 to 0.821, P<0.001; GGvs.AA: OR=0.659, 95%CI 0.606 to 0.717, P<0.001; AGvs.AA: OR=0.762, 95%CI 0.714 to 0.814, P<0.001), rs11649743 variants (Avs.G: OR=0.875, 95%CI 0.820 to 0.941, P<0.001; AAvs.GG: OR=0.669, 95%CI 0.564 to 0.792, P<0.001; AGvs.GG: OR=0.855, 95%CI 0.798 to 0.916, P<0.001), rs7501939 variants (Avs.G: OR=0.833, 95%CI 0.807 to 0.859, P<0.001), rs3760511 variants (Avs.C: OR=0.834, 95%CI 0.803 to 0.868, P<0.001) and risk of prostate cancer.ConclusionsCurrent evidence shows that HNF1B gene variants are associated with risk of prostate cancer. Due to limited quantity and quality of the included studies, more high quality studies are required to verify the above conclusion.
ObjectiveTo evaluate the effect of different rehydration strategies on the incidence of spinal anesthesia-induced hypotension and neonatal outcomes during elective cesarean section.MethodsWe searched PubMed, Embase, the Cochran Library, China National Knowledge Internet, VIP database, Wanfang database, and China Biology Medicine database from inception to January 2018, to collect randomized controlled trials (RCTs) about the incidence of spinal anesthesia-induced hypotension during elective cesarean section and neonatal outcomes of preloading or coloading. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the study. Meta-analysis was conducted using RevMan 5.3 software.ResultsA total of 11 RCTs were included, including 894 parturients, of whom 448 cases in the preload group and 446 cases in the coload group. Comparing with the preload group, the incidence of spinal anesthesia-induced hypotension during cesarean section in the coload group significantly decreased [risk ratio (RR)=1.27, 95% confidence interval (CI) (1.13, 1.43), P<0.000 1]. Subgroup analysis showed that in the crystalloid fluid group, the difference in the incidence of hypotension between the preload group and the coload group was statistically significant [RR=1.48, 95%CI (1.26, 1.73), P<0.000 01]; while in the colloidal fluid group, the difference in the the incidence of hypotension between the preload group and the coload group was not significant [RR=1.00, 95%CI (0.85, 1.17), P=0.96]. The lowest systolic blood pressure, the incidence of nausea and vomiting, and neonatal outcomes had no significant difference between the two groups.ConclusionsComparing with preloading crystalloid fluid, rapid infusion of crystalloid fluid at the same time implementation of spinal anesthesia could significantly reduce the incidence of hypotension during cesarean section while there was no superiority in infusion of colloid fluid. There was no significant effect on the severity of hypotension, nausea and vomiting, and neonatal outcomes. Due to the limitation of the quantity and quality of the included studies, the above conclusions need to be verified by more high-quality studies.
Background Tongxinluo capsule is a new drug for cardio- cerebral vascular diseases on the national essential drug list of China, and the second-class award of National Science and Technology Development of China, 2001. Objective This review aims to assess the effect (harms and benefits) of Tongxinluo capsule for unstable angina. Search strategy electronic searchs The Cochrane Heart Review Group specialised trials register,The Cochrane Controlled Trials Register, published in the latest issue of the Cochrane Library, MEDLINE, EMBASE, CBM, Chinese Cochrane Centre Controlled Trials Register, Current Controlled Trials (www. controlled-trials. com), The National Research Register Handsearchs We will search 83 journals of Chinese traditional medicine. Inclusion riteria We will include randomised controlled trials of Tonxinluo capsule versus placebo or other current phamarcotherapy or other Chinese medicinal herbs in the participants with unstable angina pectoris. Studies will report mortality (sudden death from acute myocardial infarction), severity of angina pectoris, frequency of acute attack angina, ECG improvement, rate of dosage reducing or taking frequency of nitroglycerine and symptom improvement, etc. Data analysis Data will be included in a meta-analysis if they are available, of sufficient quality and sufficiently similar.