The Mechanism of AMPK Regulate Endoplasmic Reticulum Stress to Resist the Epithelial Cell Apoptosis in COPD Rats / 现代生物医学进展

Objective:To explore the effect and mechanism of AMPK on apoptosis of alveolar epithelial cells induced by endoplasmic reticulum stress in COPD rats.Methods:the rats were divided into three groups:control group,model group,AICAR intervention group,establishment of rat model of chronic obstructive pulmonary disease by smoking smoke inhalation and intratracheal instillation of lipopolysaccharide.The HE staining of rat lung tissue pathological observation,immunohistochemical detection of p-AMPK /AMPK,western blot the expression of Caspase-3,ORP 150,and CHOP.Apoptosis were detected by TUNEL method.Results:the HE staining showed that the model group of pulmonary bullae formation,inflammatory cell infiltration,inflammatory ceils in AICAR group was lower than that of model group.Compared with the normal control group,immunohistochemistry and Western blot showed that p-AMPK/AMPK and ORP150 protein expression decreased in the model group,the difference was statistically significant (P＜0.05),and AICAR in the intervention group p-AMPK/AMPK and ORP150 protein expression were significantly increased compared with the model group,the difference was statistically significant (P＜0.05).Endoplasmic reticulum stress related apoptosis The expression of CHOP and caspase-3 apoptosis index increased significantly in the model group,there was significant difference compared with normal group (P＜0.05),while in group AICAR,apoptosis index down significantly compared with the model group.Conclusion:AMPK can protect alveolar epithelial cells from cigarette smoke induced endoplasmic reticulum stress and apoptosis,it was possible to achieve its protective effect the increase of ORP150.

Protection of noninvasive limb ischemic preconditioning on myocardium in patients undergoing heart valve surgery under cardiopulmonary bypass / 中南大学学报(医学版)

OBJECTIVE@#To determine the mechanism of protective effect of noninvasive limb ischemic preconditioning (NIPC) on myocardium of patients with rheumatic heart disease undergoing heart valve surgery under cardiopulmonary bypass (CPB).@*METHODS@#A total of 32 patients with rheumatic heart disease undergoing heart valve surgeries under CPB were randomly divided into 2 groups: a control group(n=16)and an NIPC group(n=16).Tourniguet was used for each patient in the NIPC group around both the upper extremities in turn, inflated for 8 min and deflated for 5 min for 3 cycles. After the anesthesia, the remaining procedures were the same as in the control group. Blood samples were collected from the central vein after the induction of anesthesia (T(1)), 5 min before aortic clamp (T(2)),30 min after aortic opening (T(3)), 6 h after the operation (T(4)), and 24 h after the operation (T(5)) to measure the concentration of cardiac troponin I and creatine kinase MB in the plasma and CGRP and ET-1 in the serum. Pathologic change of the right auricle of the heart tissue during the superior vena cave intubation and extubation was detected.@*RESULTS@#The content of cardiac troponin I and creatine kinase MB at T(4) and T(5) in the 2 groups was higher than that of other time points in the same group, and it reached the peak at T(5). Comparison of the content of cardiac troponin I and creatine kinase MB at T(4) and T(5) in the 2 groups showed significant difference, and that of the NIPC group was lower than the control group(P<0.05).CGRP and ET-1 contents reached the peak at T(2) in the NIPC group and at T(3) in the control group, but the peak of CGRP in the NIPC group was higher than that in the control group(P<0.01).The peak of ET-1 content in the NIPC group was lower than that in the control group(P<0.01). After the CPB, myocardial and mitochondrion impairment was lighter in the NIPC group than in the control group.@*CONCLUSION@#Noninvasive limb ischemic preconditioning can protect the myocardium through increasing CGRP, inhibiting ET-1, and advancing the peak of CGRP and ET-1.

Emergency treatment of aortic dissection and clinical pathway discussion / 中华急诊医学杂志

Objective To investigate the clinical features of aortic dissection (AD) and emergency treatments. Methods Data from 784 patients with aortic dissection were collected in the Department of Emergency from January 2000 through December 2009. A retrospective analysis was carried out to determine the survival rate, mortality rate and treatment efficiency. Results Pain was the most common onset symptom (77.7% , 609/784). The majority of patients (86.5%) had essential hypertension (678/784). All the patients with preoperative diagnosis of aortic dissection underwent emergency medical intervention by internists resulting in 81.5% survival rate (639/784) and 18.5% mortality rate (145/784). There were 157 patients without improvement (20.0% ) and the total efficiency rate was (83. 1% ). The efficiency rate of conventional treatment was 76.4% , while the efficiency rate of triple four-procedure treatment was 89. 8% (P<0.05). Of them, 139 patients (17. 7% ) died in the hospital. Among them,. 26 patients died within 24 hours (18.4% ) and 47 cases died within 48 hours (33. 8% ) and 66 patients died within 72 hours (47.2% ). There were 92 patients who refused treatments after diagnosis, and among them, 81 patients died within 72 hours (88.04% ). The difference in mortality rate between two groups was significant (P<0.05). Conclusions The diagnosis of aortic dissection depends on detailed history, physical examination and CT or MRI imaging. Analgesia, sedation and control of blood pressure are essential for emergency treatments. Early diagnosis and effective emergency treatments are the critical strategy for the early surgical intervention and time window for further treatment to improve the survival rate of AD.

Effect of morphine preconditioning on mitochondrial permeability transition pore after myocardial ischemia-reperfusion injury in rats / 中南大学学报(医学版)

Objective To investigate the effect of morphine preconditioning on mitochondrial permeability transition pore (MPTP) and its protective mechanism after myocardial ischemia-reperfusion injury. Methods A rat model of ischemia-reperfusion injury was established. Forty rats were injected with 2-3[H] DOG and then divided into 4 groups randomly: a sham operation (S) group, an ischemia-reperfusion injury (IR) group, a morphine preconditioning (Mp+IR) group, and a cyclosporine A preconditioning (CsA+IR) group. We monitored the concentrations of serum creatine kinase-Mb (CK-Mb) and cardiac troponin I (cTnI), and measured myocardial mitochondrial 2-3[H] DOG, cytochrome c content, Ca2+ concentration ([Ca2+]m), the velocity of Ca2+ intake and reaction half time of mitochondrial permeability transition pore (MPTP t1/2) in the 4 groups. Results The concentrations of serum CK-Mb and cTnI decreased more in the Mp+IR group and the CsA+IR group than those of the IR group. The concentrations of 2-3[H]DOG and [Ca2+]m in the IR group were evidently higher but the level of cytochrome c was lower than those of the sham operation group. The concentrations of 2-3[H] DOG and [Ca2+]m in the Mp+IR group decreased whereas the concentration of cytochrome c increased compared with those in the IR group. Mitochondrial 2-3[H]DOG content was positively correlated with the concentration of calcium (r=0.797, P<0.01). The 2-3[H]DOG and [Ca2+]m content were negatively correlated with cytochrome c in the IR group (r=-0.805 and r=-0.648, respectively, P<0.01). MPTP t1/2 in the IR group was shortened evidently, and that in the Mp+IR and CsA+IR group was significantly lengthened. Conclusion Morphine preconditioning may have myocardial protective effect through unburdening the calcium overload and lengthening the MPTP t1/2.

A Clinical Comparison of the Therapeutic Effect and Safety of Naloxone, Flumazenil and Naloxone Combining Flumazenil in Treatment of Acute Poisoning by Diazepam / 中国医师杂志

Objective To compare the therapeutic effect and safety of naloxone ,flumazenil and naloxone combined wiht flumazenil in treating acute diazepam poisoning and to find out ideal therapeutic treatment.Methods 45 patients were divided into three groups at random: naloxone group (n=15), flumazenil group (n=15) and naloxone combined with flumazenil group (n=15). Besides given the same routine therapy to each group, naloxone group received 0.4mg naloxone through intravenation and 1.2mg naloxone through intravenous drip; flumazenil group received 0.1mg flumazenil through intravenation and 0.9mg flumazenil through intravenous drip; naloxone combined with flumazenil group received 0.4mg naloxone and 0.1mg flumazenil through intravenation and 1.2mg naloxone and 0.9mg flumazenil through intravenous drip. Each patient's consciousness status was graded after given drug treatment 0, 5,15,60,90,180 minute. Testing the BR, SR, CK, CK-MB of every patient and recording to the Bp, HR, RR, SpO 2 and the rhythm of the heart continuously. Results At the point of 5 minute, the therapeutic efficiency of the group with combined drug use was higher than that of the naloxone group ( P