8周间歇运动和G-CSF动员对心梗大鼠心肌组织VEGF/VEGF-2的影响

摘要：目的：探讨8周间歇运动和G-CSF动员对MI大鼠心肌血管新生数量及血管再生通路因子VEGF/VEGFR-2的影响。方法：3月龄雄性SD大鼠,体质量185~210 g,结扎LAD建立MI模型。术后存活的大鼠随机分为假手术对照组（A组）、MI组（B组）、间歇运动+MI组（C组）、动员剂+MI组（D组）和间歇运动+动员剂+MI组（E组）,每组10只。C组和E组进行8周跑台间歇运动训练,8周后免疫组织化学方法染色测定VEGF、VEGFR-2表达量和CD31表达数量,用血管墨汁灌注法对心肌梗死区血管形成情况进行观察。结果：免疫组化结果显示,各干预手段均可上调MI大鼠心肌VEGF、VEGFR-2 、CD31表达（数）量,且E组＞D组＞C组;血管墨汁染色结果显示,各干预手段均可促进心肌梗死区血管、血管网的形成。结论：间歇运动和/或G-CSF均显著上调了MI大鼠心肌血管再生通路因子VEGF /VEGFR的表达,促进血管再生,增加血管新生数量,且间歇运动联合G-CSF动员的双重作用效果更佳,可能与2者有效动员内皮祖细胞（EPCS）数量和能力,参与、分化为新生血管有关。该研究为有效的治疗缺血性心脏病提供基础实验依据。     

心梗后进行有氧运动干预对大鼠心脏TH、TNF-α和ROS水平的关系探讨

摘要: 目的:探讨心梗后进行4周有氧运动干预对大鼠心脏交感神经标记物TH,促炎因子TNF-α与氧化应激水平的关系。方法: 选取雄性SD大鼠36只,随机分为假手术对照组(SC),心肌梗死组(MI),心梗+持续有氧运动组(ME),每组12只。MI组采用心脏左冠状动脉前降支(LAD)结扎法,建立MI模型。SC组大鼠实施假手术,ME组大鼠在MI手术后一周进行4跑台运动。运动以10 m/min速度开始,运动5 min后,以3 m/min的速度递增至16 m/min。运动总时间均为60 min,5 d/周×4周。训练结束后测定各组大鼠心电图变化。之后开胸摘取心脏,进行组织学制片。免疫组化法观察分析左心室交感神经标记物TH及促炎因子TNF-α表达。Western Blot法检测TH及TNF-α蛋白含量。DHE法检测心肌超氧阴离子水平。结果: 与SC组相比,MI组大鼠左心室中可见大量TH阳性神经纤维(P<0.01),其蛋白表达显著增加(P<0.01)。同时TNF-α蛋白表达及超氧阴离子水平显著升高(均P<0.01)。与MI组比较,ME组左心室TH,TNF-α蛋白表达及超氧阴离子水平均显著下降(P<0.05, P<0.01, P<0.01)。且发现左心室TH表达与ROS水平呈显著正相关(R=0.53, P<0.05),而TH与TNF-α相关性不显著 (R=0.41, P=0.11)。结论: 心梗后早期进行四周持续有氧运动干预可抑制心梗大鼠心脏交感神经标志物TH,其可能与抑制心肌氧化应激水平关系密切,与炎性细胞因子TNF-α水平关系不显著。     

国外青年脑梗死文献计量学分析

本文利用NoteExpress2文献管理工具,选取PubMed数据库,以主题=(Cerebral infarction)AND(Young)进行检索,选取数据集进行清理后,基于文献计量统计、词共现、社会网络等分析方法,运用VOSviewer、Gopubmed、Excel等工具,对青年脑梗死文献发表的时间、作者、期刊、国别及其研究热点等进行分析。     

Concurrent pulmonary thrombosis with systemic embolism: a case report

Based on different mechanisms of blood coagulation, coexistence of venous thromboembolism and arterial thrombosis in a single individual is extremely rare in clinical practice. Both antiplatelet and anticoagulation therapy should be adopted for patients with arteriovenous embolism. Balancing the risk of ischemia and hemorrhage is especially challenging in these patients in order to achieve an optimal clinical benefit. We report on a 55-year-old female with acute pulmonary embolism (PE), subsequently diagnosed as having acute myocardial infarction (AMI) and a cerebral infarction. Examinations had been carried out, excluding potential arteriovenous shunts, cancer, antiphospholipid syndrome and other common hypercoagulable states. A combination of an anticoagulant drug (rivaroxaban, an Xa inhibitor) and an antiplatelet agent (clopidogrel, an ADP receptor inhibitor) was prescribed with a β-blocker and atorvastatin. The embolus was gradually shrunk during the next 10 months, and then it turned back into expanding. During the 16 months’ follow-up, an aneurysm of left ventricular apex was found through an echocardiogram and an angiotensin-converting enzyme inhibitor was administered. We conclude that combined anticoagulation and antiplatelet therapy significantly relieved the symptoms and improved the prognosis in patients suffering from arteriovenous embolism without any major clinical bleeding events.     

缺血性脑卒中(IS)早期生物学诊断标志物研究进展

缺血性脑卒中(即脑梗死)是一种高致残率及高致死率的急症,其发病率随着人口老龄化的到来呈增高趋势,严重威胁老年人的生命健康,同时是目前世界第三大死因,在心血管病造成的死亡中,其位居第二。相比高收入国家,我国等一些中低收入国家缺血性卒中的死亡率尤为严重,为保证做出准确的早期诊断,制定有效治疗方案并改善预后,充分了解其早期生物学检测指标已迫在眉睫。     

EPO对全脑缺血后低氧诱导因子1α及存活素表达的调节

[目的]研究促红细胞生成素对全脑缺血再灌注大鼠缺氧诱导因子1α和凋亡相关蛋白存活素的调节,探讨其抗凋亡的可能机制。[方法]将成年雄性SD大鼠75只按随机数字表法分为全脑缺血组（n=35）和全脑缺血EPO干预组（n=35）,然后按再灌注时间不同又分为6h、12h、24h、48h、72h、5d和7d七个亚组。采用改良的Pu刘lsineli 4-VO法制作全脑缺血大鼠模型。应用TUNEL染色检测再灌注后不同时间点海马CA1区的神经元凋亡水平,免疫组织化学方法检测再灌注后不同时间点海马CA1区缺氧诱导因子1α和存活素表达水平的变化。[结果]全脑缺血EPO干预组24h至7d亚组TUNEL阳性神经元计数分别为1.50±0.73、3.14±0.88、5.78±1.03、7.78±1.79、10.34±1.82.与全脑缺血组相应时间点亚组相比明显减少,差异均有统计学意义（P〈0.05）。全脑缺血EPO干预组48h至5d亚组HIF-1α表达阳性细胞计数分别为11.26±0.02、20.28±2.03、3.33±0.04,与全脑缺血组相应时间点亚组相比明显减少,差异均有统计学意义（P〈0.05）.全脑缺血EPO干预组24h至5d亚组survivin蛋白表达阳性细胞计数分别为12.21±1.04、16.34±4.02、24.33±3.03、30.52±5.04,与全脑缺血组相应时间点亚组相比明显增高,差异均有统计学意义（P〈0.05）。[结论]在全脑缺血急性期,EPO抑制HIF-1α的表达而使存活素表达升高,具有一定的神经保护作用.     

Glycogen phosphorylase isoenzyme BB in the diagnosis of acute myocardial infarction: a meta-analysis

Background

Early diagnosis is crucial for management of patients with suspected acute myocardial infarction (AMI). Among innovative and promising biomarkers, the recent interest raised on glycogen phosphorylase isoenzyme BB (GPBB) has prompted us to perform a meta-analysis of published studies.

Materials and methods:

A systematic electronic search was carried out on PubMed, Web of Science and Google Scholar, with no date restriction, to retrieve all articles that have investigated the early diagnostic performance of GPBB in patients with suspected AMI, and directly reported or allowed calculation of sensitivity and specificity. A meta-analysis of the reported sensitivity and specificity of each study and pooled area under the curve (AUC) was then performed by random effect approach. Heterogeneity was assessed by I-square statistics.

Results:

Eight studies were finally selected for analysis (941 subjects; 506 cases and 435 controls), with a high heterogeneity (I-squared, 86.3%). The resulting pooled estimates and 95% confidence interval were 0.854 (0.801–0.891) for sensitivity, 0.767 (0.713–0.815) for specificity, 0.826 (0.774–0.870) for negative predictive value, 0.802 (0.754–0.844) for positive predictive value, and 0.754 (0.602–0.907) for AUC. In those studies that have simultaneously assessed GPBB and a troponin immunoassay, the combination of these biomarkers did not significantly improve the performance of troponin alone.

Conclusion:

GPBB does not meet the current requirements for an efficient diagnosis of AMI when used as a stand-alone test, whereas its combination with troponin merits further investigation in larger trials.     

β-受体阻断剂对心脏康复跑台运动时机能、生理、临床和感觉反应的影响

目的：测试服用和未服用β-受体阻断剂的心梗后患者（PMIP）在跑台运动中其功能、生理、临床及自我感觉方面的反应。方法：46名服用β-受体阻断剂的男性PMIP和55名未服用β-受体阻断剂的男性PMIP进行递增负荷运动实验，其间记录每级负荷时的摄氧量（VO2）、心率（HR）、血压和自我用力感觉（RPE），并持续监测12导联心电图（ECG）。结果：服用β-受体阻断荆的患者其安静时和运动中的HR、最大心率百分比（％HRmax）及心率血压乘积（RPP）显著低于未服用β-受体阻断剂的患者（P〈0．01）。运动中，服用β-受体阻断剂的患者有59％能够完成改良布鲁斯跑台方案的第Ⅳ级运动，而在未服用β-受体阻断剂的患者中仅有49％能完成这一负荷。两组在运动中各级别VO2、RPE及ST段下移无显著性差异。结论：由β受体阻断剂所致的HR降低并没有直接地影响到氧利用和代谢机能。     

特殊学校的教师对教育康复课程的看法——关于广州康复实验学校的个案研究

本文以广州康复实验学校为案例,对学校教育康复课程设置中教师的看法进行了实证性研究。研究的方法论基础是扎根理论。研究数据主要来源于对10位不同教龄、性别和专业背景的教师的深入访谈。研究表明,学校教师对学校教育课程的看法主要表现为以下3个方面:(1)康教结合;(2)潜能开发;(3)社会适应能力发展。文章对这3个主题分别进行了解析。