血清ACE2/Ang(1～7)与风湿性心脏瓣膜病患者心房颤动发生的相关性分析

目的分析风湿性心脏瓣膜病患者血清ACE2/Ang(1~7)的浓度与心房颤动发生之间的相关性,探讨ACE2/Ang(1~7)在风湿性心脏瓣膜病房颤发生中的作用,探寻房颤的预防及治疗的新靶点。方法收取风湿性心脏瓣膜病患者[46例,其中心房颤动(AF)组24例,窦性心律(SR)组22例]基本临床资料及外周静脉血,用ELISA法检测血清中ACE2、Ang(1~7)、AngⅡ的浓度,分析两组间的差异及相关性。结果 AF组可见以下改变:1左心房直径明显大于SR组[(60.70±3.08 vs.48.15±2.16)mm,P<0.05];2血清AngⅡ浓度[(45.88±2.87 vs.35.78±1.08)pg/mL,P<0.05]明显高于SR组,同时AngⅡ与左心房直径呈正相关(Pearson检验,P<0.05);3血清ACE2浓度[(7.87±0.74 vs.11.65±0.57)U/L,P<0.05]及Ang(1~7)浓度[(146.05±17.61 vs.321.71±36.50)pg/mL,P<0.05]显著低于SR组,与左心房直径呈负相关(Pearson检验,P<0.05);4血清Ang(1~7)与AngⅡ浓度呈负相关(Pearson检验,P<0.05)。结论在风湿性心脏瓣膜病患者中,ACE2/Ang(1~7)可能通过拮抗AngⅡ抑制心房的重构,对于房颤的发生具有保护作用。     

脑电双频指数调控下的全凭静脉麻醉在小儿腹腔镜手术中的应用

目的探讨脑电双频指数(BIS)调控丙泊酚静脉麻醉在小儿腹腔镜手术中应用的可行性。方法择期行腹腔镜手术的男性患儿40例,随机分为BIS调控丙泊酚静脉麻醉组(Ⅰ组)和丙泊酚持续泵入组(Ⅱ组),比较两组术中麻醉药用量、血流动力学、血气变化及拔管时间;检测两组术中不同时点血浆皮质醇(Cor)、去甲肾上腺素(NE)、肾上腺素(E)、促肾上腺皮质激素(ACTH)的水平。结果Ⅰ组丙泊酚用量明显低于Ⅱ组[(110.0±7.2)μg/(kg.min)vs.(131.0±8.5)μg/(kg.min),P<0.05],拔管时间短于Ⅱ组[8.2±2.1]minvs.(13.4±4.3)min,P<0.05];Ⅰ组心率(HR)、平均动脉压(MAP)在插管时、气腹前两个时点低于Ⅱ组(P<0.05),余各时点血流动力学差异无统计学意义;血气变化各时点差异无统计学意义;Ⅰ组Cor、NE、E、ACTH水平在插管时、气腹前两个时点低于Ⅱ组(P<0.05),余各时点上述各指标差异无统计学意义。结论 BIS监测可减少丙泊酚用量并缩短患儿拔管时间,维持血流动力学稳定,降低应激反应,在小儿腹腔镜手术中的应用是可行的。     

肝硬化大鼠肝脏组织病理学及血流动力学变化

目的 通过建立大鼠肝硬化模型,了解肝硬化形成过程中门静脉血流动力学的变化.方法 雄性健康SD大鼠100只随机等分为5组:4个实验组(80只,每组20只)采用腹腔及皮下注射四氯化碳(CCl4),同时饮用酒精溶液进行诱导;对照组(20只)给予普通饮水和饲料.分别于2、4、7、10周后观察肝脏的组织病理学改变及门静脉血流动力学变化.结果肝硬化过程中肝细胞经历变性、坏死、纤维组织增生及假小叶的形成;血流动力学检测指标发生相应变化,平均动脉压(MAP)表现为逐渐下降,门静脉压力(PVP)、下腔静脉压(IVCP)及门静脉阻力(PVR)表现为逐渐升高,门静脉血流量(PVF)表现为先升高后下降,内脏血管阻力(SVR)表现为先下降后升高.结论本方法可建立稳定的肝硬化门脉高压症模型,且适于大批量制作;在大鼠肝硬化门脉高压形成过程中门静脉血流动力学及肝组织病理学均发生了变化,可用于肝硬化门脉高压症方面的相关研究.     

肠系膜淋巴管结扎对脓毒症相关肺脏损伤及肠道损伤的作用

目的观察肠系膜淋巴管结扎(mesenteric lymph duct ligation,MLDL)对脓毒症大鼠肺脏及肠道功能的影响。方法采用大鼠盲肠结扎穿孔(cecal ligation and puncture,CLP)法制备脓毒症模型。大鼠按随机数字表法分为假手术对照组(Sham组)、脓毒症组(CLP组)及MLDL组(CLP+MLDL组,CLP联合肠系膜淋巴管结扎处理),在脓毒症造模24h后收集各组大鼠的血液、肺脏及小肠组织标本行功能及病理学检查,同时检测血液、肺脏及小肠组织中的细菌负荷水平。结果 CLP造模24h后,血气分析及肺脏组织病理学检测结果显示,MLDL可以显著减轻脓毒症大鼠的肺损伤评分(6.14±0.51 vs.8.12±0.63,P=0.029 9),提升氧分压[(78.67±4.51)mmHg vs.(64.83±2.90)mmHg,P=0.027 3],降低肺脏湿/干比(6.12±0.25 vs.7.63±0.49,P=0.021 2),降低肺泡灌洗液中炎症因子[TNF-α:(828.17±81.89)pg/mL vs.(1 118.17±79.22)pg/mL,P=0.029 1;IL-6:(39.33±5.50)ng/mL vs.(68.67±5.24)ng/mL,P=0.003 4]、蛋白(2.117±0.289 2 vs.3.033±0.164 7,P=0.020 3)及细胞[(30.00±3.587)×10~6/L vs.(43.83±2.358)×10~6/L,P=0.009 1)]的水平。小肠屏障功能及病理学检测结果发现,MLDL未能减轻肠道损伤;MLDL可以明显降低血液及肺脏组织中的细菌负荷水平,但是对于小肠组织中的细菌水平则无明显改变。结论 MLDL能够显著减轻脓毒症大鼠的肺损伤,但是对于肠道损伤则无明显保护作用。这种作用差异可能与MLDL可以抑制脓毒症时细菌从腹腔往其他脏器扩散,但是会导致在腹腔脏器特别是肠道组织内积聚有关。     

钠、钾干预对Dahl盐敏感大鼠肾髓质TGF-β1表达及纤维化的影响

目的观察高盐摄入及补钾对Dahl盐敏感大鼠血压、肾髓质转化生长因子-β1(TGF-β1)及纤维化水平的影响,探讨TGF-β1在盐敏感高血压形成及靶器官损害中的作用。方法 6周龄雄性Dahl盐敏感大鼠(n=24)及SS-13BN大鼠(n=24)各3组,分别给予含4g/kg NaCl(低盐组)、80g/kg NaCl(高盐组)及80g/kg NaCl+80g/kg KCl(高盐补钾组)饮食干预4周。于干预前后测量大鼠尾动脉压。采用RT-PCR和免疫组化法测定肾髓质TGF-β1的表达,并用Masson染色观察肾髓质区的纤维化。结果经4周干预,Dahl盐敏感大鼠高盐组血压较低盐组明显升高[(169.9±2.2)mmHg vs.(147.1±6.1)mmHg,P<0.01],高盐补钾组较高盐组血压明显下降[(123.6±3.8)mmHg vs.(169.9±2.2)mmHg,P<0.01]。SS-13BN大鼠高盐组较低盐组血压升高[(145.6±1.9)mmHg vs.(140.2±3.7)mmHg,P<0.05],高盐补钾组较高盐组血压下降[(125.2±2.8)mmHg vs.(145.6±1.9)mmHg,P<0.01]。Dahl盐敏感大鼠高盐组TGF-β1mRNA及蛋白表达量较低盐组明显升高(0.87±0.02 vs.0.67±0.04,P<0.01;0.136±0.002 vs.0.030±0.002,P<0.01),高盐补钾组TGF-β1mRNA及蛋白表达量较高盐组明显减少(0.55±0.04 vs.0.87±0.02,P<0.01;0.070±0.008 vs.0.136±0.002,P<0.01)。Dahl盐敏感大鼠肾小管区胶原沉积高盐组多于低盐组(0.075±0.002 vs.0.037±0.002,P<0.01),高盐补钾组则较高盐组减少(0.038±0.008 vs.0.075±0.002,P<0.01)。结论高盐可使Dahl盐敏感大鼠血压明显升高,肾髓质区TGF-β1表达明显增加及纤维化。补钾对高盐引起的血压升高及靶器官损害有保护作用。     

超重对行胃癌根治术患者近期临床疗效的影响

目的探讨超重对于胃癌根治术近期疗效的影响。方法回顾性收集2009年1月至2012年12月于我科行胃癌根治术的患者166例(超重组102例,非超重组64例),比较两组患者术中、术后以及近期生存情况。结果超重组手术时间明显长于非超重组[(237.70±59.16)min vs.(210.55±54.49)min,P<0.05)),术中出血量亦明显高于非超重组[(346.41±223.63)mL vs.(276.77±155.46)mL,P<0.05)];两组的术中总淋巴结清扫数、肛门排气时间、进食时间、术后住院时间以及术后并发症的差异均无统计学意义。超重组和非超重组的3年生存率分别为76.8%和65.1%,差异无统计学意义(P>0.05)。结论超重会延长手术时间和增加术中的出血量,但不会影响手术的近期疗效。     

贝前列素钠对低氧性肺动脉高压大鼠的作用及对肺动脉平滑肌氧敏感性K_V通道表达的影响

目的探讨贝前列素钠(BPS)对低氧性肺动脉高压(HPH)大鼠的疗效,及其对肺动脉平滑肌氧敏感性KV通道表达的影响。方法采用在低压低氧舱内每日饲养8h的方法建立HPH大鼠模型;BPS干预组每日给予BPS灌胃[300μg/(kg·d)],对照组和模型组给予生理盐水灌胃;4周后测定平均肺动脉压力(mPAP),计算右心肥厚指数(RVHI),肺组织切片HE染色评价肺动脉壁增厚程度,Real-time PCR和Western blot检测肺小动脉平滑肌KV1.2、KV1.5、KV2.1mRNA和蛋白表达水平。结果连续4周低压低氧成功诱导HPH大鼠模型;与模型组相比,BPS干预后mPAP和RVHI降低[mPAP:(13.48±2.18)mmHg vs.(23.87±2.23)mmHg vs.(17.09±1.20)mmHg;RVHI:0.28±0.02 vs.0.46±0.03 vs.0.36±0.04;P<0.05];肺小动脉重构改善(中膜面积百分比:35.72±6.58 vs.68.52±5.64 vs.46.58±8.43,P<0.05),肺动脉平滑肌KV1.2、KV1.5、KV2.1mRNA和蛋白表达水平升高(蛋白相对表达量:KV1.2,0.78±0.10 vs.0.15±0.03 vs.0.57±0.13;KV1.5,0.61±0.10 vs.0.31±0.05 vs.0.59±0.13;KV2.1,0.29±0.05 vs.0.10±0.02 vs.0.28±0.07;P<0.05)。结论 BPS可改善HPH大鼠的肺动脉高压,并上调肺动脉平滑肌KV1.2、KV1.5、KV2.1的表达。     

斜外侧入路病灶清除植骨融合联合经皮内固定术治疗单节段腰椎结核的临床观察

目的比较斜外侧入路微创通道下病灶清除植骨融合联合经皮椎弓根螺钉内固定术与开放前后路联合病灶清除植骨融合内固定术治疗腰椎结核的临床效果。方法收集西安交通大学第一附属医院自2017年3月至2020年1月收治的47例腰椎结核患者临床资料,其中接受斜外侧入路微创通道下病灶清除植骨融合联合经皮椎弓根螺钉内固定术的患者22例(微创组),接受开放前后路联合病灶清除植骨融合内固定术的患者25例(对照组)。收集两组患者的年龄、性别、体质指数、有无结核全身症状等一般资料,比较患者手术时间、术中出血量、术后引流量、住院时间及并发症等围手术期相关指标,以及患者术前和术后3个月、6个月及末次随访时视觉模拟评分(VAS)、血沉(ESR)、Oswestry功能障碍指数(ODI)评分、腰椎前凸Cobb角及植骨融合情况。结果两组患者手术均顺利完成,术前一般资料差异无统计学意义(P>0.05)。微创组患者手术时间[(188.64±18.59)min vs.(201.60±22.67)min]、术中出血量[(118.64±22.95)mL vs.(553.60±100.54)mL]、术后引流量[(134.55±36.48)mL vs.(291.20±61.53)mL]、住院时间[(12.86±2.17)d vs.(15.80±3.03)d]均少于对照组,差异具有统计学意义(P<0.05),而融合时间及并发症发生率差异无统计学意义(P>0.05)。与术前比较,两组患者术后随访各时间点ESR、VAS评分、ODI评分均降低,腰椎前凸Cobb角增大,差异具有统计学意义(P<0.001);微创组患者仅术后3个月的VAS评分小于对照组[(3.59±0.96)vs.(4.16±0.85)],差异具有统计学意义(P<0.05),而两组间同一时间点其余各指标差异无统计学意义(P>0.05)。结论斜外侧入路微创通道下病灶清除植骨融合联合经皮椎弓根螺钉内固定与开放手术治疗腰椎结核均可取得良好的临床效果,而微创技术可减小手术创伤、缩短住院时间,加速患者术后康复。     

山莨菪碱在非转流经典原位肝移植中的应用

目的观察山莨菪碱对非转流经典原位肝移植术血流动力学、氧代谢和肾功能的影响。方法选择行非转流经典原位肝移植患者30例,ASA分级Ⅲ-Ⅳ,随机分为山莨菪碱组和对照组,每组15例。山莨菪碱组术中使用1 g/L山莨菪碱10 mg/h,对照组使用相同容量的生理盐水。分别于术前、无肝期前、无肝期30 min、新肝期60 min和术毕测定血流动力学、组织氧代谢和肾功能指标。结果与无肝期前相比,两组无肝期30 min中心静脉压(CVP)明显降低,新肝期60 min CVP明显升高(P<0.05);两组间各时点的心率(HR)、平均动脉压(MAP)和CVP均无显著性差异(P>0.05);两组手术时间、无肝期时间、出血量、总入量均无显著性差异(P>0.05);与对照组相比,山莨菪碱组尿量显著增多(P<0.05),而速尿的用量显著减少(P<0.05);两组肌酐(Cr)和β2-微球蛋白(β2-MG)术中各时点与术前相比及两组之间相比差异均无统计学意义(P>0.05)。与术前比较,两组无肝期30 min乳酸盐(LAC)水平明显增高,持续至术毕(P<0.01);与对照组相比,山莨菪碱组在无肝期30 min后各时点LAC明显降低(P<0.05)。结论肝移植术中使用山莨菪碱能改善组织微循环,增加术中尿量,对改善肾功能有一定意义。     

血管生成素-2对冠状动脉支架术后支架内再狭窄的预测价值

目的探讨血清血管生成素-2(Ang-2)对冠心病患者经皮冠状动脉介入治疗(PCI)术后支架内再狭窄的预测价值。方法入选113例冠心病患者成功置入单个药物洗脱支架,术后9~12个月复查冠状动脉造影,依据冠状动脉造影结果将患者分为支架术后再狭窄组和无再狭窄组,采用酶联免疫吸附法(ELISA)测定PCI术前及术后1周血清Ang-2浓度。结果支架内再狭窄组12例患者,无再狭窄组101例患者。再狭窄组和无再狭窄组术前Ang-2浓度[(849.6±234.6)pg/mL vs.(796.9±198.7)pg/mL]差异无统计学意义(P>0.05),术后Ang-2浓度[(629.7±137.3)pg/mL、(504.3±107.6)pg/mL]均明显下降,两组比较差异有统计学意义(P<0.05)。无再狭窄组术后Ang-2浓度降低更为明显,低于再狭窄组,差异有统计学意义(P<0.05)。结论 PCI术后Ang-2浓度均明显降低,且无再狭窄组降低更明显,推测Ang-2与支架术后再狭窄相关,可作为预测PCI术后支架内再狭窄的参考指标。     

In situ absorption and metabolism of stilbene glycoside in rat

Stilbene glycoside (TSG) has been shown to have many beneficial properties. It is therefore essential to understand the absorption and metabolism of TSG in detail. We determined the recovery of TSG and its metabolites (TSG sulfate/glucuronides) in rat gastric contents, gastric mucosa, portal vein plasma, celiac arterial plasma, bile, and urine after administration of 15mg of TSG in 0.5mL physiological saline or incubation for 20min in situ in the stomach of rats. Within 20min, (64.0±9.8)% of the administered TSG disappeared from the stomach; later, TSG was recovered in both free and conjugated forms in plasma and bile, but not in urine. On the other hand, only free TSG was detected in the gastric contents and mucosa; it was also detected in the portal vein plasma as (48.1±3.5)% of the total TSG (all forms of TSG). However, the proportion of free TSG in the celiac arterial plasma and bile decreased to 4%-10%. In addition, the proportion of free TSG to total TSG in the liver microsome incubation mixture after TSG was incubated in liver microsome at 37℃ for 30min was very low [(10.6 ± 2.6)%]. These results indicate that TSG could be quickly absorbed from the rat stomach, conjugated in liver and excreted in bile. Such novel information would be helpful for the use of TSG as a beneficial natural product which may improve its proposed efficacy in preventing chronic diseases.     

Effect of ulinastatin on hepatic ischemia-reperfusion injury in rats

Objective To investigate the effect of ulinastatin (UTI) on hepatic ischemia-reperfusion injury in rats. Methods Totally 24 adult Sprague-Dawley rats were randomly divided into 3 groups: sham-operated control group (SO group), ischemia-reperfusion group (I/R group) and ulinastatin group (UTI group). Liver in I/R group underwent 1 h of reperfasion after 30 min of ischemia. In UTI group, UTI (2×104 U/kg) was administered to rats 30 min before modeling. The levels of alanine aminotransferase, aspartate aminotransferase and tumor necrosis factor-alpha (TNF-α) in serum were measured and the levels of nitric oxide and malondialdehyde in liver were determined. The histological changes of liver were observed. Results The levels of alanine aminotransferase, aspartate aminotransferase and TNF-α in serum were significantly increased in I/R group compared with those in UTI group (P<0.05). The levels of nitric oxide and malondialdehyde in liver were significantly higher in I/R group than in UTI group (P<0.05).Histological examination of liver indicated that the damages were more severe in I/R group than in UTI group.Conclusion UTI has the ability to inhibit the production of TNF-α and oxyradical, and ameliorate microcirculatory dysfunction in rats with hepatic ischemia-reperfasion injury.     

EXPLORE ON DIAGNOSTIC AND PROGNOSTIC VALUES OF EXTRAHEPATIC CHOLANGIOCARCINOMA： UTILITY OF SERUM CA19-9 AND SERUM CEA

Extrahepaticcholangiocarcinoma (EHCC)isamalignanttumorarisingfrombileductepithelium .Unlikemosthumancancers ,atissuediagnosisofcholangiocarcinomaisoftenextremelydifficultbe causeoftumorlocation ,size ,anddesmoplasticcharacteristics .Percutaneousfineneedleaspirationisfrequentlynotpossiblebecausemanyofthesetu morsarelocatedintheliverhilumamidlargevascu larstructure .Furthermore ,tumormassesareoftennotevenidentifiablebyCT ,ultrasound ,ormag neticresonanceimaging .Endoscopicapproachesarealsoofl…     

彩色多普勒超声在动态监测移植肝及其并发症中的应用

目的探讨彩色多普勒超声在动态监测肝移植术后血流动力学变化及并发症诊治中的应用价值。方法回顾我中心107例原位肝移植术后应用彩色多普勒超声资料,汇总后行统计学分析。结果肝移植术后早期门脉流速较正常对照组升高,而肝动脉流速降低,后逐渐恢复正常。107例中发现肝动脉血栓形成2例(1.87%),肝动脉狭窄5例(4.67%),门脉血栓形成3例(2.80%),肿瘤复发7例(6.54%),诊断为急性排斥反应18例次(16.82%),慢性排斥反应10例次(9.34%),胸腔积液105例(98.13%),腹腔积液65例(60.74%),假性动脉瘤1例,胰漏1例,胆道感染4例(3.74%),胆道狭窄4例(3.74%),胆漏5例(4.67%),胆总管结石1例。结论彩色多普勒超声在动态监测肝移植术后血流动力学变化及并发症诊治中具有重要的临床意义。     

Role of candesartan against cerebral ischemia and oxidative damage in normotensive rats

Objective Angiotensin Ⅱ (Ang Ⅱ ) contributes to modulating blood pressure by stimulation of Ang Ⅱ AT1 receptors. We devised a rat transient middle cerebral artery occlusion (MCAO) model to assess whether oxidative damage is decreased after pretreatment with Angiotensin Ⅱ AT1 receptor blocker (ARB). Methods After 2 weeks pretreatment with ARB 0. 5 and 1 mg/kg, the male Wister rats were subjected to 2 h middle cerebral artery occlusion (MCAO). At 24 h, the lumen diameter of middle cerebral artery, the plasma level of 8-hydroxy-2'-deoxyguanosine (8-OHdG), and HIF-1 a levels were recorded and compared. Results After pretrcatment with ARB 0.5 and 1 mg/kg, blood pressure did not significantly change compared with that of controls. In the group of candesartan at 1 mg/(kg· day), the lumen diameter was significantly increased compared to that in control group [(86.0±5.0) μm vs. (69.0± 2.1) μm; P<0. 01, n = 6- 8]. The plasma 8-OHdG levels of ARB pretreatment groups were decreased. In immunohistochemical findings, 8-OHdG- and HIF-1α-containing cells in ARB pretreatment groups were decreased. Conclusion Brain ischemia and oxidative damage can be reversed by AT1 receptor blockade in normotensive rats after transient cerebral artery occlusion.     

A PULSATION-TYPE PORTAL PUMP IN THE TREATMENT OF THE PORTAL HYPERTENTION

Ｌｉｖｅｒｃｉｒｒｈｏｓｉｓ ,ａｗｏｒｌｄｗｉｄｅｈｅａｌｔｈ ｐｒｏｂｌｅｍ ,ｄｅｃｒｅａｓｅｓｔｈｅｂｌｏｏｄｆｌｏｗｔｈｒｏｕｇｈｔｈｅｌｉｖｅｒ .Ｔｈｉｓｉｎｔｕｒｎｌｅａｄｓｔｏｄａｎｇｅｒｏｕｓ ｐｏｒｔａｌｈｙｐｅｒｔｅｎｓｉｏｎａｎｄｄｅｃｒｅａｓｅｄｍｅｔａｂｏｌｉｃｆｕｎｃｔｉｏｎｗｉｔｈｉｎｔｈｅｌｉｖｅｒ .Ｔｈｅｓｕｒｇｉｃａｌｔｈｅｒａｐｅｕｔｉｃｔｒｅａｔｍｅｎｔｓｎｏｗａｄａｙｓｃａｎ’ｔｓｏｌｖｅｔｈｅｐｒｏｂｌｅｍｓｕｃｃｅｓｓｆｕｌｌｙ .Ｔｈｅｄａｎｇｅｒｏｆｂ…     

THE EFFECT OF FCγ RECEPTOR ON THE PATHOGENESIS OF GRAVES'' DISEASE

Objective To explore the roles of Fcγ receptor in the pathogenesis of Graves' disease. Methods Fcγ receptor gene knockout mice(Fcγ R KO mice) which were rooted in C57BL/6 mice and wild type C57BL/6 mice were immunized by hTSH receptor expressing cells (DAP3.WT).1-2×107 DAP3.WT cells were peritoneally injected into mice every two weeks for a total of six times.Two weeks after final immunization, mice were killed for measurement of total thyroxine,TRAb and pathological examination.Results The thyroxine level of the immunized Fcγ receptor gene knockout mice was significantly lower than that of the immunized wild type control mice (2.2±0.31 vs.3.32±0.59g·dL-1,P<0.05), but there was no significant difference between immunized Fcγ R KO mice and non-immunized wild type control group.The TRAb levels of the immunized Fγ R KO mice significantly increased compared to those of the immunized wild type mice (21.75±8.21 vs.14.11±6.21, P<0.05). The lymphocyte cells infiltration and destruction of thyroid follicles were found in the thyroid gland of the immunized Fcγ R KO mice. Conclusion　These results suggest that Fcγ receptor may be involved in the pathogenesis of Graves'disease.     

原位肝移植对胃黏膜pH的影响

目的　探讨非转流原位肝移植术对胃黏膜pH(gastricintraumucosalpH ,pHi)的影响。 方法　选择 2 0例行非转流原位肝移植术的患者 ,采用胃管法 ,分别于入室、无肝期前 2 0min、无肝期 30min、新肝期 30min、术后 2、2 4h抽取胃液 3～ 5mL ,分析胃液的PCO2 ,同时在以上各时点监测动脉血PaCO2 、PaO2 、pH、HCO3 -和BE ,并代入Henderson Hasselbach公式计算pHi。结果　pHi在无肝期 30min、新肝期 30min均显著低于术前水平 (P <0 .0 1) ,且新肝期 30minpHi为最低点。术后 2h虽较术前有所回升 ,但仍有显著性差异 (P <0 .0 5 )。结论　肝移植阻断下腔静脉后胃黏膜有明显的缺血低灌注现象。随着阻断时间延长 ,胃黏膜低灌注、酸中毒的症状加重。提示术前选用抗酸药物治疗 ,术中减少血流动力学的波动、尽量缩短无肝期的时间对提高pHi、保护胃黏膜、减少术后并发症、改善预后有一定的临床意义。     

EFFECTS OF OUABAIN AND DIGOXIN ON THE GENE EXPRESSION OFSODIUM PUMP α-SUBUNIT ISOFORM IN AORTIC SMOOTH MUSCLE OF RATS

Accumulating evidence indicates that endoge-nous ligands of the digitalis receptor may exist inthe mammalian body, which has recently been de-scribed to be indistinguishable from ouabainL1'2j.Endogenous ouabain (EO) might induce many cy-tobiological changes and play an important role inregulating water and sodium metabolism and vas-cular tone in the body["'J. Many studies haveshowed that EO content in both hypertensive pa-tients and hypertensive animals is much more thanthose of normal subje…