【摘要】 目的 探討胎兒宮內窘迫對足月新生兒血清心肌酶變化的相關性分析。 方法 將2009年10月-2010年9月在我產科出生有宮內窘迫史而羊水和Apgar評分均正常的足月新生兒20例為觀察組，同期出生的健康足月新生兒10例為對照組，分別測定兩組出生后1、5 d血清肌酸激酶同工酶（CK-MB）及心肌肌鈣蛋白I（cTnI）水平。 結果 觀察組出生后1 d血清cTnI高于對照組（Plt;0.001），CK-MB兩組差異無統計學意義（Pgt;0.05），出生后5 d血清CK-MB及cTnI均高于對照組（Plt;0.001）；觀察組和對照組出生后5 d血清cTnI水平均較1 d時升高，差異有統計學意義（Plt;0.001），血清CK-MB濃度均低于1 d時（Plt;0.001）。觀察組患兒經過治療，1個月后復查血清cTnI除1例未恢復至正常水平外，其余血清CK-MB及心電圖均恢復正常。 結論 單純宮內窘迫可造成足月新生兒血清cTnI及CK-MB水平升高，常規檢測血清cTnI及CK-MB能及時了解此類新生兒的心肌受損情況，從而盡早予以保護心肌治療。【Abstract】 Objective To make a correlation analysis on effect of fetal distress on changes of cardiac enzyme in neonatal serum. Methods Twenty full-term newborns who met diagnostic criteria of fetal distress but were born with normal amniotic fluid and Apgar score between October 2009 and September 2010 were included in the observed group, another ten normal full-term newborns born at same period were in control group. The serum values of cardiac troponin I (cTnI) and creatine kinase (CK-MB) were collected and measured one and five days after birth. Results One day after the birth, the serum levels of cTnI was significantly higher in the observed group compared to that in the control group (Plt;0.001), but there was no difference in CK-MB between the two groups (Pgt;0.05). The values of cTnI five days after the birth were higher than those one days after the birth in both groups (Plt;0.001). The values of CK-MB were higher one day after birth than those five days after birth in both groups (Plt;0.001). In observation group after the treatment, serum cTnI in one patient did not return to normal, and the remaining neonatal serum CK-MB and ECG were normal. Conclusions Elevated level of serum cTnI and CK-mb could be caused by fetal distress in normal full-term newborns with normal amniotic fluid and Apgar score. Routine testing of serum cTnI and CK-MB may be useful to detect myocardial damage in newborns.
【摘要】 目的 觀察在腹腔鏡膽囊切除術中，氯胺酮超前鎮痛對瑞芬太尼麻醉后急性疼痛的影響。 方法 2009年10月-2010年1月，將擇期行腹腔鏡膽囊切除術患者90例，隨機分為對照組（C組）、氯胺酮超前鎮痛組（K組）、氯胺酮術畢鎮痛組（K1組），每組30例。所有患者均采用瑞芬太尼復合丙泊酚靜脈麻醉，K組在切皮前靜脈給予氯胺酮0.5 mg/kg，K1組在關腹前靜脈給予氯胺酮0.5 mg/kg，C組不給予任何藥物。記錄術畢患者麻醉恢復情況，各時間點疼痛程度。 結果 K組、K1組躁動發生率均明顯低于C組（Plt;0.05）；術后2、4、8、24 h，K組VAS評分及鎮痛藥使用率明顯低于C組和K1組（Plt;0.05）。 結論 氯胺酮超前鎮痛能明顯降低瑞芬太尼術后疼痛，并且不增加并發癥發生率。【Abstract】 Objective To evaluate the preemptive analgesia of ketamine on remifentanil induced acute postoperative pain after laparoscopic cholecystectomy. Methods Ninty patients scheduled for laparoscopic cholecystectomy between october 2009 to Jannary 2010 were randomly assigned to three groups (n=30). Group K was administrated with 0. 5 mg/kg ketamine intravenously before skin incision, and Group K1 were administrated with 0. 5 mg/kg ketamine intravenously before abdominal closure, while Group C received nothing. The recovery and the side effects were recorded, the VAS at two, four, eight and 24 hours after surgery, and the use of anodyne were recorded. Results The incidence of restlessness in Groups K and K1 was remarkably lower than that of Group C (Plt;0. 05). The analgesic effects two, four, eight and 24 hours after surgery were obviously better in group K than those of Group C and Group K1 (Plt;0. 05). Conclusion Ketamine can produce preemptive analgesia to relieve remifentanil-induced acute pain, and it would not increase incidence of side effects.
【摘要】 目的 觀察晚期糖基化終產物（advanced glycosylation end prodrcts，AGE）對人結腸癌細胞株SW-480增殖的影響，并探討其可能機制。 方法 不同濃度AGE干預SW-480細胞，噻唑藍（MTT）法比較各組細胞活力，流式細胞術觀察AGE對SW-480細胞周期的影響，蛋白質印跡法觀察AGE對SW-480細胞CyclinD1表達的影響，端粒重復序列擴增法（telomeric repeat amplification protocol，TRAP）銀染法觀察AGE對SW-480細胞端粒酶活性的影響。MTT測細胞活力的檢測設置空白對照組、100 μg/mL小牛血清白蛋白（bovine serum albumin，BSA）組及50、100、500 μg/mL AGE組，其余檢測只設置100 μg/mL BSA組和100 μg/mL AGE組。 結果 MTT結果示AGE促進SW-480細胞的增殖，且呈濃度依賴性。100 μg/mL BSA組與100 μg/mL AGE組72 h后的細胞G0/G1期所占百分比分別為56.02%±0.58%、51.93%±1.01%，差異有統計學意義（Plt;0.05）。蛋白質印跡法示100 μg/mL AGE組72 h后CyclinD1的表達較100 μg/mL BSA組增加，差異有統計學意義（Plt;0.05）。TRAP銀染法檢測示100 μg/mL AGE干預SW-480細胞72 h后可以增加端粒酶活性（Plt;0.05）。 結論 AGE可促進人結腸癌細胞SW-480生長，呈劑量依賴性。其作用機制可能與AGE上調CyclinD1的表達加速G1/S期轉換及增加端粒酶活性有關。【Abstract】 Objective To observe the effects of advanced glycosylation end products (AGE) on proliferation of SW-480 cells and study the possible mechanism. Methods Various concentrations of AGE were designed to have impact on SW-480 cells. Proliferation of SW-480 cells was assessed by thiazolyl blue tetrazolium bromide (MTT) assay; The impact of AGE on the cell cycle of SW-480 cells was analyzed by flow cytometry (FCM); the influence of AGE on expression of CyclinD1 was checked by Western blotting; and the impact of AGE on telomerase activity was examined by telomeric repeat amplification proctol (TRAP) sliver staining. For the MTT assay, blank control group, 100 μg/mL bovine serum albumin (BSA) group, 50, 100 and 500 μg/mL AGE groups were designed, while for other examinations, there were only 100 μg/mL BSA group and 100 μg/mL AGE group. Results MTT result showed that AGE increased the proliferation of SW-480 cells in a dose-dependent mode. The proportion of the cells at G0/G1 stage of the 100 μg/mL BSA group and the 100 μg/mL AGE experimental group were (56.02±0.58)% and (51.93±1.01)% respectively after 72 hours, with a significant difference (Plt;0.05); western blotting showed that the expression of CyclinD1 in the 100 μg/mL AGE group was significantly higher than that in the 100 μg/mL BSA group after 72 hours; TRAP silver staining demonstrated that telomerase activity increased significantly after treated with 100 μg/mL AGE for 72 hours. Conclusions AGE can promote the growth of SW-480 cells in a dose-dependent mode. Its mechanism is mainly by up-regulating the expression of CyclinD1 to shorten G0/G1 and increasing the telomerase activity significantly.
