应激致高血压大鼠神经核团c-fos蛋白表达及细胞凋亡的研究

为探讨应激性高血压大鼠发病中血管紧张素II(AII)的作用,通过足底电击结合噪声刺激制备了应激性高血压大鼠,对急性应激大鼠不同时间血浆中的AII含量进行了测定.结果表明:应激刺激导致的高血压与血浆AII浓度增加有关,并与c-fos蛋白表达和细胞凋亡有关.中枢缰核、下丘脑外侧核、杏仁中央核、岛叶神经元等参与了此过程.     

肺压宁胶囊治疗慢性阻塞性肺病73例疗效观察

目的:观察纯中药复方制剂———肺压宁胶囊(CapFYN)对慢性阻塞性肺病(COPD)的长期疗效。方法:选取确诊的COPD患者73例,分为治疗组42例,对照组31例。两组基础治疗相同(均不使用氨茶碱),治疗组用肺压宁胶囊每次4粒,每天3次;对照组用硝苯吡定片剂10mg每天3次,对比观察治疗20周前后患者的咳嗽、咳痰、神疲、乏力等症状,舌腹静脉瘀血征,肺功能(1s用力呼气容积/用力肺活量即FEV1/FVC)以及平均肺动脉压的组内和组间变化,并计算它们的危险度(Risk)、相对危险度(RR)、相对危险度减少(RRR)和绝对危险度减少(ARR)值,以评价治疗效果。结果:随访率分别为98%和99%;神疲、乏力症状、瘀血征、肺功能、肺高压4项结果的RR值均>1,症状的RRR为-0 476,余3项的RRR值均<-0 5,4项的ARR值依次为26 11%、43 80%、24 29%、22 39%;两组患者肝肾功能及血、尿常规均无明确改变。结论:肺压宁胶囊是一种长期服用方便、安全,能改善病人症状、瘀血征和气道气流阻塞及降低肺动脉高压的纯中药复方制剂,可作为COPD患者综合治疗的一种辅助方药。     

Regulation of sodium and body fluid homeostasis during development: Implications for the pathogenesis of hypertension

The spontaneously hypertensive rat (SHR) is an important animal model of human essential hypertension. During the first month of life, increased retention of sodium is present in the SHR which appears to be mediated by the renin-angiotensin system. The present review will discuss the role that increased activity of the renin-angiotensin system plays in sodium/body fluid regulation during early development. It is hypothesized that disordered regulation of sodium/body fluid homeostasis during this stage leads to pathological cardiovascular regulation in adulthood. Through an understanding of the relationship between sodium/body fluid balance in the young and cardiovascular function in the adult insights may be gained into both the pathological state of hypertension and the critical role played by early development in shaping homeostatic mechanisms in adulthood.     

高血压脑出血并发消化道出血的临床分析(附179例报告)

对 179例高血压脑出血患者 ,按脑出血的部位、血肿量、有无脑室积血和中线结构移位 ,分别进行比较并发消化道出血的发生率和病死率 .结果表明 :179例中并发消化道出血 4 4例 (2 4 .6 % ) ,死亡 37例 (2 0 .7% ) ;消化道出血发生率以脑基底节区出血并脑室积血为最高 (38.9% ) ,其次依序为蛛网膜下腔、脑干、脑叶、小脑和局限于脑基底节区出血 ;并发消化道出血的病死率为 50 % ,无消化道出血的病死率为 11.1% .脑出血并发消化道出血主要与出血溢入脑室、中线结构移位、血肿量大等因素有关 ,且病死率高 .     

Endothelium-derived nitric oxide and vascular physiology and pathology

In 1980, Furchgott and Zawadzki demonstrated that the relaxation of vascular smooth muscle cells in response to acetylcholine is dependent on the anatomical integrity of the endothelium. Endothelium-derived relaxing factor was identified 7 years later as the free radical gas nitric oxide (NO). In endothelium, the amino acid L-arginine is converted to L-citrulline and NO by one of the three NO synthases, the endothelial isoform (eNOS). Shear stress and cell proliferation appear to be, quantitatively, the two major regulatory factors of eNOS gene expression. However, eNOS seems to be mainly regulated by modulation of its activity. Stimulation of specific receptors to various agonists (e.g., bradykinin, serotonin, adenosine, ADP/ATP, histamine, thrombin) increases eNOS enzymatic activity at least in part through an increase in intracellular free Ca²⁺. However, the mechanical stimulus shear stress appears again to be the major stimulus of eNOS activity, although the precise mechanisms activating the enzyme remain to be elucidated. Phosphorylation and subcellular translocation (from plasmalemmal caveolae to the cytoskeleton or cytosol) are probably involved in these regulations. Although eNOS plays a major vasodilatory role in the control of vasomotion, it has not so far been demonstrated that a defect in endothelial NO production could be responsible for high blood pressure in humans. In contrast, a defect in endothelium-dependent vasodilation is known to be promoted by several risk factors (e.g., smoking, diabetes, hypercholesterolemia) and is also the consequence of atheroma (fatty streak infiltration of the neointima). Several mechanisms probably contribute to this decrease in NO bioavailability. Finally, a defect in NO generation contributes to the pathophysiology of pulmonary hypertension. Elucidation of the mechanisms of eNOS enzyme activity and NO bioavailability will contribute to our understanding the physiology of vasomotion and the pathophysiology of endothelial dysfunction, and could provide insights for new therapies, particularly in hypertension and atherosclerosis.     

Inhaled and exhaled nitric oxide

Inhaled nitric oxide (NO) is used to treat various cardiopulmonary disorders associated with pulmonary hypertension. The rationale is based on the fact that NO, given by inhalation, only dilates those pulmonary vessels that perfuse well-ventilated lung units. As a result, pulmonary gas exchange is improved while pulmonary vascular resistance is reduced and pulmonary blood flow is increased. Inhaled NO has been succesfully applied to treat persistent pulmonary hypertension of the newborn, reducing the need for extracorporeal life support. Although pulmonary hypertension and altered vasoreactivity contribute to profound hypoxaemia in adult and paediatric acute respiratory distress syndrome (ARDS), the benefit of inhaled NO still remains to be established in patients with ARDS. ARDS is a complex response of the lung to direct or indirect insults, leading to pulmonary vasoconstriction and various inflammatory responses. Recent randomized trials suggest that inhaled NO only causes a transient improvement in oxygenation. Whether this effect is important in the long-term management of ARDS remains to be established. NO, measured in the exhaled breath, is an elegant and non-invasive means to monitor inflammation of the upper and lower respiratory tract. In the normal upper airways, the bulk of exhaled NO originates from the paranasal sinuses. Exhaled NO is increased in nasal allergy and decreased in cystic fibrosis, nasal polyposis and chronic sinusitis. That NO production is increased in asthmatic airways is also well established. However, several questions still need to be addressed, in particular evaluation of the sensitivity and specificity of the measurement techniques, and assessment of the bronchodilator action of endogenous NO.     

LHI注射液抗野百合碱致大鼠肺动脉高压的实验研究

目的 :观察LHI注射液抗野百合碱 (MCT)致大鼠肺动脉高压 (PH)和右心室肥大的影响。方法 :给SD大鼠一次腹腔注射MCT(60mg.kg-1)复制PH模型 ,2wk后用LHI注射液进行治疗 ,连续8d,然后用孙波法测定肺动脉压。结果 :MCT所致大鼠肺动脉高压和右心室肥大模型效果确切 ,平均肺动脉压升高、右心室/心脏重量比、肺湿/干重比值增大 ,与对照组相比 ,P<0.001(18.47±1.32VS11.02±1.21) ;使用LHI治疗后 ,肺动脉压有所降低 ,与模型组相比P<0.05(13.31±1.12VS18.47±1.32)。结论 :MCT造成肺动脉高压模型效果确切 ,LHI注射液对MCT所致的肺动脉高压有一定的对抗作用。     

老年高血压病患者脉压与心功能关系初探

目的 :探讨老年高血压病患者脉压与心功能的关系 ,尤其是与左室收缩功能与舒张功能的关系。方法 :应用动态血压监测(ABPM)及超声心动图观察68例老年高血压病患者。根据脉压大小将患者分为 :①A组 :平均脉压>40mmHg;②B组 :平均脉压≤40mmHg。结果 :脉压与A/E比值、年龄呈明显正相关(P<0 05,P<0 01)。A组血清总胆固醇(Tc)、收缩压(SBP)、甘油三酯(TG)明显高于B组(P<0 05、0 01、0 05。结论 :老年高血压病患者脉压主要影响左室舒张功能     

从2002年教职工体检情况谈“三高”的防控

目的 定期检查教职工健康状况，统计高血压、高血脂、高血糖症的发病率，以利及时预防、控制．方法 各科常规检查，辅助检查为胸透、心电图、血生化、腹部B超、测量血压、体重等．结果 受检1598人，患病1313人，占受检总数82．6％，其中“三高”患者508人，占受检总数32％．结论 江南大学教职工身体健康状况不容乐观，应倡导健康教育，开展“三高”预防与控制．     

心理社会因素,行为形式与高血压的研究

本文用流行病学回顾性调查法探讨了心理社会因素，行为形式与原发性高血压的关系，１３８例患者的调查资料表明：家族史，劳动强度，人际关系，左心功能，皮肤由阻潜伏期和体重指数等因素在高血压组和对照组之间有明显的差异。在高血压患者中具有Ａ型性格者占１６．８％，而对照组占１０％，Ｂ型性格则有相反的趋势，相关分析表明：家族史，劳动强度，人际关系，左心功能，皮肤电阻潜伏期，体重指数，住房条件，神经质性格与高血压呈