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控制性萎陷的肺保护作用实验研究
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作者 卢薪 严笑 +6 位作者 刘高望 唐建军 刘晓军 张艾兴 杨雪莹 古妙宁 肖金仿 《国际麻醉学与复苏杂志》 CAS 2018年第10期938-943,976,共7页
目的 通过一种新型单腔肺隔离导管通气工具对开胸手术犬行控制性肺萎陷通气的肺保护作用。 方法 实验犬18只,采用随机数字表法分为3组(每组6只),全身麻醉后经口插入控制肺内平衡分气肺隔离导管,行股动脉穿刺、置管,右颈内静脉穿... 目的 通过一种新型单腔肺隔离导管通气工具对开胸手术犬行控制性肺萎陷通气的肺保护作用。 方法 实验犬18只,采用随机数字表法分为3组(每组6只),全身麻醉后经口插入控制肺内平衡分气肺隔离导管,行股动脉穿刺、置管,右颈内静脉穿刺置入Swan-Ganz漂浮导管。首先均行双肺通气(two-lung ventilation, TLV)20 min,后进行左侧单肺通气(one-lung ventilation, OLV),右肺萎陷程度依次为100%(完全肺萎陷组,A组),90%(90%肺萎陷组,B组),50%(50%肺萎陷组,C组),各组均在肺萎陷前1 min(T1)、肺萎陷后30 min(T2)、肺萎陷后60 min(T3)、肺萎陷后120 min(T4)经股动脉和颈内静脉取血行血气分析测定肺内分流率(intrapulmonary shunt rate, Qs/Qt)、测定细胞间黏附分子-1(intercellular adhesion molecule 1, ICAM-1)及丙二醛(malondialdehyde, MDA)含量、超氧化物歧化酶(superoxide, SOD)活性。实验过程中持续监测HR、股动脉血压(arterial blood pressure, ABP)、平均肺动脉压(mean pulmonary arterial pressure, MPAP)、PETCO2、肛温等生命体征。 结果 各组在TLV时测得的各方面生理指标差异均无统计学意义(P>0.05);OLV后,各组MPAP在T2、T3、T4时较T1时均升高(P<0.05);与A组比较,B组、C组MPAP较为平稳,差异有统计学意义(P<0.05),B组、C组间各方面生理指标差异无统计学意义(P>0.05);与T1时比较,3组肺内分流率Qs/Qt在T2、T3、T4时明显升高(P<0.05),血清ICAM-1、MDA含量在T2、T3、T4时升高(P<0.05),SOD活性在T2、T3、T4时下降(P<0.05);在T2、T3、T4时,B组、C组Qs/Qt低于A组(P<0.05),血清ICAM-1、MDA含量低于A组(P<0.05),SOD活性高于A组(P<0.05);C组血清ICAM-1、MDA含量低于B组(P<0.05),SOD活性高于B组(P<0.05)。 结论 与完全肺萎陷(萎陷程度100%)相比,控制性肺萎陷(萎陷90%和萎陷50%)更利于减轻OLV的肺损伤,对肺具有保护作用。萎陷50%与萎陷90%相比作用明显,提示萎陷50%可能具有更显著的肺保护作用。 展开更多
关键词 单肺通气 控制性肺萎陷 肺保护
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Short-term intensive atorvastatin therapy improves endothelial function partly via attenuating perivascular adipose tissue inflammation through 5-lipoxygenase pathway in hyperlipidemic rabbits 被引量:2
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作者 Wang Xiaoqiao Lin Yongqin +4 位作者 Luo Niansang Chen Zhongqing gu miaoning Wang Jingfeng Chen Yangxin 《Chinese Medical Journal》 SCIE CAS CSCD 2014年第16期2953-2959,共7页
Background Atherosclerosis is a kind of disease with multiple risk factors,of which hyperlipidemia is a major classical risk factor resulting in its pathogenesis and development.The aim of this study was to determine ... Background Atherosclerosis is a kind of disease with multiple risk factors,of which hyperlipidemia is a major classical risk factor resulting in its pathogenesis and development.The aim of this study was to determine the effects of short-term intensive atorvastatin (IA) therapy on vascular endothelial function and explore the possible mechanisms that may help to explain the clinical benefits from short-term intensive statin therapy.Methods After exposure to high-fat diet (HFD) for 8 weeks,the animals were,respectively,treated with IA or low-dose atorvastatin (LA) for 5 days.Blood lipids,C-reactive protein (CRP),tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),nitric oxide (NO),endothelin-1 (ET-1),and endothelium-dependent vasorelaxation function were,respectively,measured.mRNA and protein expression of CRP,TNF-α,IL-6,macrophage chemoattractant protein-1 (MCP-1),and 5-lipoxygenase (5-LO) were also evaluated in pericarotid adipose tissue (PCAT) and cultured adipocytes.Results HFD increased serum inflammatory factor levels; induced significant hyperlipidemia and endothelial dysfunction,including imbalance between NO and ET-1; enhanced inflammatory factors and 5-LO expression; and promoted macrophage infiltration into adipose tissue.Five-day IA therapy could significantly decrease serum inflammatory factor levels and their expression in PCAT; restore the balance between NO and ET-1; and improve endothelial function and macrophage infiltration without significant changes in blood lipids.However,all of the above were not observed in LA therapy.In vitro experiment found that lipopolysaccharide (LPS) enhanced the expression of inflammatory factors and 5-LO in cultured adipocytes,which could be attenuated by short-time (6 hours) treatment of high-dose (5 pmol/L) but not low-dose (0.5 μmol/L) atorvastatin.In addition,inhibiting 5-LO by Cinnamyl-3,4-dihydroxy-α-cyanocinnamate (CDC,a potent and direct 5-LO inhibitor) could significantly downregulate the above-mentioned gene expression in LPS-treated adipocytes.Conclusion Short-term IA therapy could significantly ameliorate endothelial dysfunction induced by HFD,which may be partly due to attenuating inflammation of PCAT through inhibiting 5-LO pathway. 展开更多
关键词 ATORVASTATIN endothelial function adipose tissue INFLAMMATION 5-lipoxygenase pathway
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