In this paper,the changes of activities of enzymes relating toenergy metabolism in rabbit's retina during acute ocular hypertension were observed.The activities of succinate dehydrogenase and adenosine triphosphatase were foud to be reduced,while the activities of the lactatic dehydrognease and glucose-6-phosphatase increased.The results reveal the disturbance of metabolism of energy in retina undergone acute ocular hypertension,and suggest that this might be the underlying factors relating to the defects of the functions and structures of the retina. （Chin J Ocul Fundus Dis,1993,9:141-144）
Objective To explore and summarize the curative effect and experience of emergency devascularization for treatment of upper gastrointestinal bleeding due to portal hypertension. Melthods The clinical data of 42 patients with upper gastrointestinal bleeding due to portal hypertension， undergoing emergency devascularization from March 2006 to July 2011 in Shengjing Hospital of China Medical University were retrospectively analyzed. Results Of the 42 cases， 29 patients underwent emergency splenectomy plus esophagogastric devascularization， 8 patients underwent emergency spleen artery ligation plus esophagogastric devascularization， and 5 patients only underwent emergency esophagogastric devascularization. The hemostasis rate at 3 hours after emergent disconnection operation was 100%. One patient died of liver failure on 8 days after operation. Three patients supervened with hemorrhage in abdominal cavity on 2 days after operation， and succeeded in hemostasis by conservative treatment. Other patients were successfullydischarged from hospital after postoperative rehabilitation for 2-4 weeks. All cases were followed up regular in 1 year after operation， 5 patients were lost to follow-up. Among the 36 cases followed up， rehaemorrhagia occurred in 1 patientin 8 months after operation， cured by endoscopic variceal ligation subsequently. A primary liver cancer occurred in 1 patient during physical examination in 7 months after operation， followed by partial hepatectomy. Other patients could complete daily life and work. Conclusions The patients suffering from upper gastrointestinal bleeding due to portal hypertension are likely to benefit from appropriate operations. Decisive emergency devascularization can stop the bleeding rapidly and effectively， and save the lives of those patients.
Objective To investigate the dynamic expression of small ubiquitin-related modifiers-1 ( SUMO-1) in lung tissue in different phases of rat model of hypoxic pulmonary hypertension( HPH) .Methods Forty Wistar rats were randomly divided into 5 groups, and exposed to normoxia or to normobaric intermittent hypoxia for 3, 7, 14 or 21 days, respectively. Mean pulmonary arterial pressure( mPAP) , right ventricle hypertrophy index ( RVHI) , and the ratio of the vessel wall area to the total area( WA% ) weremeasured. RT-PCR and in situ hybridization were used to determine the mRNA expression of SUMO-1.Immunohistochemistry and Western blot were used to determine the protein expression of SUMO-1. Results The hypoxic rats developed pulmonary vascular remodeling in pulmonary arterioles after 7 days of hypoxia,with WA% and mPAP significantly higher than those in the normal control. Pulmonary vascular remodeling aggravated with much higherWA% and mPAP afer 14 days of hypoxia, and reached the peak afer 21 days of hypoxia. SUMO-1 mRNA and protein expression markedly increased after 3 days of hypoxia, and reached peak after 14 days. After 21 days of hypoxia, SUMO-1 mRNA expression weakened but still higher than that in the normal control ( P lt; 0. 05) , and SUMO-1 protein expression remained stable. SUMO-1 mRNA and protein expression were positively correlated with mPAP, WA% and RVHI( all P lt; 0. 01) . Conclusion SUMO-1 is transcriptionally induced in lung tissue under chronic hypoxia, and thus involves in the pathogenesis of HPH.
After analysising 15 patients with portal hypertension (PHT) in secondary biliary cirrhosis due to hepatolithiasis, the authors consider that the surgical procedure depends on indivedual’s specificity: majority of patients with PHT but no hemorrhage may be treated by removing the hepatobiliary stone, resolving the bile duct stricture and then reconstructing it as the first step. Whether or not to dispose of PHT depended on the postoperative condition. If the patient had previous hemorrhage and is accompanied by severe obstructive jaundice, splenectomy with shunt and simple biliary external drainage is the choice and removal of stone with biliary tract reconstruction will be performed in the second stage. Meanwhile, it is very important to monitor perioperative condition of the patient and treat the complications.
【摘要】 目的 探讨降高血压药物联合抗焦虑抑郁药物万拉法新治疗老年性原发高血压伴焦虑抑郁障碍的疗效及安全性。 方法 纳入2006年10月-2008年10月我院门诊和住院诊治的老年性原发高血压伴焦虑抑郁障碍患者100例,随机分为干预组和对照组。所有患者给予常规降压药物治疗,干预组另外给予万拉法新治疗,治疗12周后评价临床疗效。结果 干预组临床降压疗效总有效率940%,显著高于对照组总有效率800%(Plt;005)。两组患者的收缩压、舒张压与治疗前比较均显著改善(Plt;005),干预组患者与对照组比较血压明显改善(Plt;005)。干预组临床抗焦虑抑郁疗效总有效率960%,显著高于对照组总有效率580%(Plt;005)。两组均无明显的不良反应。结论 降高血压药物联合抗焦虑抑郁药物万拉法新治疗老年性原发高血压伴焦虑抑郁障碍疗效肯定,且安全可靠,值得临床推广应用。【Abstract】 Objective To investigate the efficacy and safety of antihypertensive drugs combined with antianxiety depression drug venlafaxine for treatment of patients with senile primary hypertension (SPH) and anxietydepression disorder (AD). Methods One hundred SPH patients with AD with were randomly divided into an intervention group and a control group. All cases were given antihypertensive drugs medication,while the intervention group was given venlafaxine. After 12 weeks of treatment,the clinical efficacy was evaluated. Results The antihypertensive efficacy rate in the intervention group was 940%,significantly higher than that of the control group 800% (Plt;005). The systolic blood pressure(SBP)and diastolic blood pressure (DBP) of the two groups significantly improved compared with those before treatment (Plt;005), and the intervention group’ SBP and DBP improved significantly than those of the control group (Plt;005). The total effective rate of antianxiety depression efficacy of the intervention group was 960%, significantly higher than that of the control group 580% (Plt;005). The two groups had no significant adverse reactions. Conclusion For patients with senile primary hypertension and anxietydepression disorder,the combination medication with antihypertensive drugs and venlafaxine was safe,reliable and worthy of clinical application.
摘要:目的:研究高血压病患者过氧化物酶体增殖物激活受体(PPAR)γ2基因Pro12Ala多态性与血糖水平之间的关系。方法:纳入177名原发性高血压患者,其中空腹血糖(FBG)lt;5.6 mmol/L组65例, FBG≥5.6 mmol/L组112例,收集一般资料;分别测定空腹及餐后2小时血糖、胰岛素;对PPARγ2 基因Pro12Ala多态性与各临床变量的关系进行研究。结果:FBGlt;5.6 mmol/L组和FBG≥5.6 mmol/L组Pro和Ala等位基因频率分别为0.333,0.034及0.602,0.031;PP和PA基因型频率分别为0.299,0.068及0.571,0.062;无AA型纯合子。以体重指数(BMI)分层后,BMIlt;25组内,FBG与PPARγ2基因型相关（P=0.029)。以基因型分组比较,PA组空腹血糖水平和胰岛素抵抗指数都低于PP组(Plt;0.05)。结论:成都地区高血压患者PPARγ2基因Pro12Ala多态性与空腹血糖水平相关,且携带Ala基因者空腹血糖水平较低,胰岛素抵抗较轻,推测该突变可能有减轻高血压病患者胰岛素抵抗,改善糖代谢异常的作用。Abstract: Objective:To study the association between the Pro12Ala polymorphism in peroxisome proliferatorsactivated receptorγ2 ( PPARγ2 ) gene and blood glucose levels in patients with primary hypertension. Methods：The Pro12Ala polymorphism in PPARγ2 was determined by polymerase chain reactionrestriction fragment length polymorphism (PCRRELP) in 177 subjects with primary hypertension of the Han people in Chengdu of China, including 65 subjects with fasting blood glucose (FBG)lt;5.6 mmol/L and 112 subjects with FBG≥5.6 mmol/L; the clinical characteristics including height, weight, OGTT(0h and 2h) of the subjects were detected and the realationship between the Pro12Ala polymorphism and the clinical characteristics were analysed. Results: The allele frequencies in the group with FBGlt;5.6 mmol/L and FBG≥5.6 mmol/L were 0.333, 0.602 for Pro and 0.034, 0.031 for Ala. The genotype frequencies were 0.299, 0.571 for PP and 0.068, 0.062 for PA, and there was no AA. In the group with BMIlt;25, the Pro12Ala polymorphism was associated with FBG （P=0.029). the Ala allele had a negative relationship to the FPG and insulin resistance index (IRI) (Plt;0.05).Conclusion: The data showed that the Pro12Ala polymorphism was associated with FBG., and The allele Ala probably had benefits to glycometabolic disturbance in patients with primary hypertension by declining insulin resistance.
Objective To evaluate the efficacy and safety of latanoprost versus travoprost for primary open-angle glaucoma (OAG) and ocular hypertension (OH). Methods All the randomized controlled trials (RCTs) about treating primary open-angle glaucoma and ocular hypertension with latanoprost and travoprost were collected by searching MEDLINE, EMbase, OVID and CNKI. The assessment of methodological quality and data extraction of the included studies were performed independently by two reviewers, and the meta-analysis was conducted with RevMan 5.0 software. Results A total of 13 RCTs involving 1 433 patients were included. The results of meta-analyses showed that, a) At the second week, travoprost showed greater intraocular pressure (IOP) lowering efficacy compared with latanoprost (WMD= –1.47, 95%CI –2.62 to –0.33). At the first month (WMD= –0.50, 95%CI –1.52 to 0.52) and the sixth month (WMD= –0.12, 95%CI –0.85 to 0.61), the difference of IOP reduction between latanoprost and travoprost group was not significant; and b) The latanoprost-treated group showed fewer reported conjunctival congestion than the travoprost-treated group (OR=0.47, 95%CI 0.35 to 0.63). The difference in adverse events of eye pain (OR=0.55, 95%CI 0.27 to 1.12) and iris or skin depigmentation (OR=1.25, 95%CI 0.53 to 2.92) between latanoprost and travoprost group was not significant. Conclusion Latanoprost and travoprost are comparable in lowering IOP for OAG and OH patients. Latanoprost shows greater ocular tolerability with lower incidence of side effects as conjunctival congestion. This conclusion is not powerful enough in proof due to the medium methodology quality of the included studies, so a large number of high-quality RCTs with large sample are needed for objectively, entirely and precisely evaluating the efficacy.
Objective To analyze the protective effects of heat-shock response on the retinae of the rats after retinal ischemic reperfusion injury.Method Twenty Wistar rats (20 eyes) were divided into 4 groups: intracameral perfusion group (group P), intracameral perfusion after quercetin injection group (group P+Q), intracameral perfusion after heat shock group (group P+H), and in tracameral perfusion after quercetin injection and heat shock group (group P+Q+H ). According to the standard program established by International Society for Clinical Visual Electrophysiology, we recorded the results of the dark-adapted electroretinogram (D-ERG ),oscillatory potentials (OPs),and light-adapted ERG (L-ERG) of the rats with intraocular hypertension after induced by heat shock response. The expressions of HSP 70 of the rats in all groups were observed by Western blotting.Results The expression of HSP 70 of the rats in group P+H was the highest in all groups, but the expressions of HSP70 in group P+Q and P+Q+H were inhibited significantly. The amplitudes of a and b wave of ERG and O2 wave of OPs decreased, and the delitescence of them were delayed significantly in rats after intracameral perfusion. The amplitude of b wave of D-ERG and O2 wave of OPs in group P+H were higher than which in group P. Zero hour after perfusion, the amplitudes of all waves in group P+H increased significantly (Plt;0.05). Twenty-four hours after perfusion, the retinal functional resumption of the rats in group P+H was better than which in group P. In group P+Q and P+Q+H, the delitescences of all waves of ERG and O2 wave of OPs were the longest and the amplitudes were the lowest, and some waves even disappeared.Conclusions The heat-shock response may improve the recovery ability of the retinal cells after injury of ischemic reperfusion.(Chin J Ocul Fundus Dis，2003，19：117-120)
摘要:目的: 比较咪达普利与培哚普利对原发性高血压患者的的降压效果和不良反应。 方法 :将入选的60例1～2级高血压病患者,随机分为2组,咪达普利组,每日晨起口服咪达普利(5～10 mg,1次/d),培哚普利组,每日晨起口服培哚普利(4～8 mg,1次/d)。治疗4周,观察2组治疗前、后的血压,记录不良反应。 结果 :经治疗后咪达普利与培哚普利组血压均明显下降(Plt;0.05),组间差异无统计学意义(P＞0.05);总不良反应发生率咪达普利组16.8%,培哚普利组20%,而咪达普利组的咳嗽发生率为6.8%,培哚普利组为16.8%。 结论 :咪达普利和培哚普利均能有效降压,二者降压效果相似,但咪达普利的咳嗽发生率较低。Abstract: Objective: To compare the antihypertensive efficacy and safety of imidapril versus peridopril in patients with essential hypertension. Methods : Selected 60 patients with mild to moderate essential hypertension, in which divided two groups by random.They were administered imidapril 5～10 mg once daily or and peridopril 4～8 mg once daily for 4 weeks. During the curative period of 4 weeks, the antihypertensive efficacy and adverse reaction were observed. Results :The blood pressure drecreased prominently in both groups after four weeks treament(Plt;0.05), but there was no significant difference in antihypertensive efficacy between the two groups(P＞0.05). The occurrence of the total adverse reaction in imidapril and peridopril groups was 16.8% and 20%, respectively, while the occurrence of the cough in two groups was 6.8% and 16.8%, respectively. Conclusion :Both imidapril and peridopril exert favourable and similar hepotensive effect, however the cough occurrence of imidapril is lower than that of peridopril.
ObjectiveTo study the concepts and pathophysiology of intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS). MethodsRelevant information was gathered from previous original articals,and by checking the latest issues of appropriate journals. Meantime computerised MEDLINE search from 1998 to August 2001 was conducted using the Medical Subject Heading and textwords “abdominal”, “compartment syndromes”, “intraabdominal” and “hypertention” and “pressure”.Then the literature in the recent two years about the advances of IAH and ACS were reviewed. Especially the concepts, pathophysiology and clinical application of IAH and ACS were mainly summarized.ResultsAkin to compartment syndrome, the pathophysiological effects of increased intraabdominal pressure developed well before any clinical evidence of compartment syndrome. These changes included ①reduction of gastrointestinal blood flow，②increase of respiratory airway pressure whereas decrease of pulmonary compliance，③decline in cardiac output but rise in peripheral vascular pressure，④oliguria even anuria，⑤increase of intracranial pressure，⑥decrease of hepatic blood flow，⑦decrease of abdominal wall compliance.ACS can be defined as dysfunction of various organs caused by a progressive unphysiologic increase of the intraabdominal pressure. Clinically the syndrome is characterised by inadequate ventilation, tensely distended abdomen and oliguria or anuria.Early decompression by simple laparotomy and delayed closure is the treatment of choice. ConclusionThe concepts of IAH and ACS have been increasingly accepted. They mainly affects the respiratory,cardiovascular and renal systems; secondarily affect gastrointestinal, central nervous systems,liver and abdominal wall. The reduction of cardiac output and pulmonary compliance are probably promoting factors inducing organ dysfunction.