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A feasible strategy for focal cerebral ischemiareperfusion injury: remote ischemic postconditioning 被引量:21
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作者 Qiang Liu Shengnian Zhou +3 位作者 Yaodong Wang Fang Qi Yuan Song Siwei Long 《Neural Regeneration Research》 SCIE CAS CSCD 2014年第15期1460-1463,共4页
It is difficult to control the degree of ischemic postconditioning in the brain and other isch- emia-sensitive organs. Remote ischemic postconditioning could protect some ischemia-sensitive organs through measures on ... It is difficult to control the degree of ischemic postconditioning in the brain and other isch- emia-sensitive organs. Remote ischemic postconditioning could protect some ischemia-sensitive organs through measures on terminal organs. In this study, a focal cerebral ischemia-reperftlsion injury model was established using three cycles of remote ischernic postconditioning, each cycle consisted of 10-minute occlusion of the femoral artery and 10-minute opening. The results showed that, remote ischemic postconditioning significantly decreased the percentage of the in- farct area and attenuated brain edema. In addition, inflammatory nuclear factor-KB expression was significantly lower, while anti-apoptotic Bcl-2 expression was significantly elevated in the ce- rebral cortex on the ischemic side. Our findings indicate that remote ischemic postconditioning attenuates focal cerebral ischemia/reperfusion injury, and that the neuroprotective mechanism is mediated by an anti-apoptotic effect and reduction of the inflammatory response. 展开更多
关键词 nerve regeneration remote ischemic postconditioning focal cerebral ischemia neuropro-tection APOPTOSIS INFLAMMATION brain injury nuclear factor-~B BCL-2 neural regeneration
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Limb remote ischemic postconditioning protects integrity of the blood-brain barrier after stroke 被引量:12
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作者 Juan Li Xiao-Song Hu +5 位作者 Fang-Fang Zhou Shuai Li You-Sheng Lin Wen-Qian Qi Cun-Fang Qi Xiao Zhang 《Neural Regeneration Research》 SCIE CAS CSCD 2018年第9期1585-1593,共9页
Integrity of the blood-brain barrier structure is essential for maintaining the internal environment of the brain.Development of cerebral infarction and brain edema is strongly associated with blood-brain barrier leak... Integrity of the blood-brain barrier structure is essential for maintaining the internal environment of the brain.Development of cerebral infarction and brain edema is strongly associated with blood-brain barrier leakage.Therefore,studies have suggested that protecting the blood-brain barrier may be an effective method for treating acute stroke.To examine this possibility,stroke model rats were established by middle cerebral artery occlusion and reperfusion.Remote ischemic postconditioning was immediately induced by three cycles of 10-minute ischemia/10-minute reperfusion of bilateral hind limbs at the beginning of middle cerebral artery occlusion reperfusion.Neurological function of rat models was evaluated using Zea Longa’s method.Permeability of the blood-brain barrier was assessed by Evans blue leakage.Infarct volume and brain edema were evaluated using 2,3,5-triphenyltetrazolium chloride staining.Expression of matrix metalloproteinase-9 and claudin-5 m RNA was determined by real-time quantitative reverse transcription-polymerase chain reaction.Expression of matrix metalloproteinase-9 and claudin-5 protein was measured by western blot assay.The number of matrix metalloproteinase-9-and claudin-5-positive cells was analyzed using immunohistochemistry.Our results showed that remote ischemic postconditioning alleviated disruption of the blood-brain barrier,reduced infarct volume and edema,decreased expression of matrix metalloproteinase-9 m RNA and protein and the number of positive cells,increased expression of claudin-5 m RNA and protein and the number of positive cells,and remarkably improved neurological function.These findings confirm that by suppressing expression of matrix metalloproteinase-9 and claudin-5 induced by acute ischemia/reperfusion,remote ischemic postconditioning reduces blood-brain barrier injury,mitigates ischemic injury,and exerts protective effects on the brain. 展开更多
关键词 nerve regeneration remote ischemic postconditioning middle cerebral artery occlusion cerebral ischemia/reperfusion blood-brain barrier acute cerebral ischemia STROKE matrix metalloproteinase-9 CLAUDIN-5 neural regeneration
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Remote ischemic postconditioning protects against gastric mucosal lesions in rats 被引量:2
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作者 Tao Wang Ye-Ting Zhou +2 位作者 Xin-Nian Chen An-Xiang Zhu Bo-Hua Wu 《World Journal of Gastroenterology》 SCIE CAS 2014年第28期9519-9527,共9页
AIM: To investigate the protective effects of remote ischemic postconditioning (RIP) against limb ischemia-reperfusion (IR)-induced gastric mucosal injury.
关键词 Remote ischemic postconditioning Limb ischemia-reperfusion Gastric ischemia Protection RAT
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Ischemic postconditioning enhances glycogen synthase kinase-3β expression and alleviates cerebral ischemia/reperfusion injury 被引量:2
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作者 Bo Zhao Wenwei Gao +2 位作者 Jiabao Hou Yang Wu Zhongyuan Xia 《Neural Regeneration Research》 SCIE CAS CSCD 2012年第19期1507-1512,共6页
The present study established global brain ischemia using the four-vessel occlusion method. Following three rounds of reperfusion for 30 seconds, and occlusion for 10 seconds, followed by reperfusion for 48 hours, inf... The present study established global brain ischemia using the four-vessel occlusion method. Following three rounds of reperfusion for 30 seconds, and occlusion for 10 seconds, followed by reperfusion for 48 hours, infarct area, the number of TUNEL-positive cells and Bcl-2 expression were significantly reduced. However, glycogen synthase kinase-3β activity, cortical Bax and caspase-3 expression significantly increased, similar to results following ischemic postconditioning. Our results indicated that ischemic postconditioning may enhance glycogen synthase kinase-3β activity, a downstream molecule of the phosphatase and tensin homolog deleted on chromosome 10/phosphatidylinositol 3-kinase/protein kinase B signaling pathway, which reduces caspase-3 expression to protect the brain against ischemic injury. 展开更多
关键词 cerebral ischemia/reperfusion glycogen synthase kinase-3β ischemic postconditioning ischemicPRECONDITIONING APOPTOSIS neural regeneration
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Neuroprotective effects of long noncoding RNAs involved in ischemic postconditioning after ischemic stroke 被引量:3
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作者 Wei Ma Chun-Yan Li +12 位作者 Si-Jia Zhang Cheng-Hao Zang Jin-Wei Yang Zhen Wu Guo-Dong Wang Jie Liu Wei Liu Kuang-Pin Liu Yu Liang Xing-Kui Zhang Jun-Jun Li Jian-Hui Guo Li-Yan Li 《Neural Regeneration Research》 SCIE CAS CSCD 2022年第6期1299-1309,共11页
During acute reperfusion,the expression profiles of long noncoding RNAs in adult rats with focal cerebral ischemia undergo broad changes.However,whether long noncoding RNAs are involved in neuroprotective effects foll... During acute reperfusion,the expression profiles of long noncoding RNAs in adult rats with focal cerebral ischemia undergo broad changes.However,whether long noncoding RNAs are involved in neuroprotective effects following focal ischemic stroke in rats remains unclear.In this study,RNA isolation and library preparation was performed for long noncoding RNA sequencing,followed by determining the coding potential of identified long noncoding RNAs and target gene prediction.Differential expression analysis,long noncoding RNA functional enrichment analysis,and co-expression network analysis were performed comparing ischemic rats with and without ischemic postconditioning rats.Rats were subjected to ischemic postconditioning via the brief and repeated occlusion of the middle cerebral artery or femoral artery.Quantitative real-time reverse transcription-polymerase chain reaction was used to detect the expression levels of differentially expressed long noncoding RNAs after ischemic postconditioning in a rat model of ischemic stroke.The results showed that ischemic postconditioning greatly affected the expression profile of long noncoding RNAs and mRNAs in the brains of rats that underwent ischemic stroke.The predicted target genes of some of the identified long noncoding RNAs(cis targets)were related to the cellular response to ischemia and stress,cytokine signal transduction,inflammation,and apoptosis signal transduction pathways.In addition,15 significantly differentially expressed long noncoding RNAs were identified in the brains of rats subjected to ischemic postconditioning.Nine candidate long noncoding RNAs that may be related to ischemic postconditioning were identified by a long noncoding RNA expression profile and long noncoding RNA-mRNA co-expression network analysis.Expression levels were verified by quantitative real-time reverse transcription-polymerase chain reaction.These results suggested that the identified long noncoding RNAs may be involved in the neuroprotective effects associated with ischemic postconditioning following ischemic stroke.The experimental animal procedures were approved by the Animal Experiment Ethics Committee of Kunming Medical University(approval No.KMMU2018018)in January 2018. 展开更多
关键词 cerebral infarction differential expression analysis expression profiling GO term ischemic postconditioning ischemic stroke KEGG pathway lncRNA mRNA RNA sequencing
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Neuroprotective effect of ischemic postconditioning on sciatic nerve transection 被引量:2
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作者 Xiao-bin Zhou Na Liu +3 位作者 Dong Wang De-xin Zou Chang-wei Wei Jun-lin Zhou 《Neural Regeneration Research》 SCIE CAS CSCD 2018年第3期492-496,共5页
Ischemic preconditioning or postconditioning has been shown to have neuroprotective effect on cerebral ischemia, but it has not been studied in peripheral nerve injury. In this study, a rat model of sciatic nerve tran... Ischemic preconditioning or postconditioning has been shown to have neuroprotective effect on cerebral ischemia, but it has not been studied in peripheral nerve injury. In this study, a rat model of sciatic nerve transection was established, and subjected to three cycles of ischemia for 10 minutes + reperfusion for 10 minutes, once a day. After ischemic postconditioning, serum insulin-like growth factor 1 expression increased; sciatic nerve Schwann cell myelination increased; sensory function and motor function were restored. These findings indicate that ischemic postconditioning can effectively protect injured sciatic nerve. The protective effect is possibly associated with upregulation of insulin-like growth factor 1. 展开更多
关键词 nerve regeneration ischemic postconditioning nerve injury insulin-like growth factor 1 sciatic nerve ISCHEMIA/REPERFUSION neural regeneration
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Effect of Minocycline Postconditioning and Ischemic Postconditioning on Myocardial Ischemia-reperfusion Injury in Atherosclerosis Rabbits 被引量:1
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作者 黄从刚 李睿 +6 位作者 曾秋棠 丁艳萍 邹永光 毛晓波 胡威 熊蓉 黎明 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2012年第4期524-529,共6页
This study examined the protective effect of ischemic postconditioning(IPoC) and minocycline postconditioning(MT) on myocardial ischemia-reperfusion(I/R) injury in atherosclerosis(AS) animals and the possible mechanis... This study examined the protective effect of ischemic postconditioning(IPoC) and minocycline postconditioning(MT) on myocardial ischemia-reperfusion(I/R) injury in atherosclerosis(AS) animals and the possible mechanism.Forty male healthy rabbits were injected with bovine serum albumin following feeding on a high fat diet for 6 weeks to establish AS model.AS rabbits were randomly divided into 3 groups:(1) I/R group,the rabbits were subjected to myocardial ischemia for 35 min and then reperfusion for 12 h;(2) IPoC group,the myocardial ischemia lasted for 35 min,and then reperfusion for 20 s and ischemia for 20 s [a total of 3 cycles(R20s/I20s×3)],and then reperfusion was sustained for 12 h;(3) MT group,minocycline was intravenously injected 10 min before reperfusion.The blood lipids,malondialdehyde(MDA),superoxide dismutase(SOD),soluble cell adhesion molecule(sICAM),myeloperoxidase(MPO),and cardiac troponin T(cTnT) were biochemically determined.The myocardial infarction size(IS) and apoptosis index(AI) were measured by pathological examination.The expression of bcl-2 and caspase-3 was detected in the myocardial tissue by using reverse transcription-polymerase chain reaction(RT-PCR).The results showed that the AS models were successfully established.The myocardial IS,the plasma levels of MDA,sICAM,MPO and cTnT,and the enzymatic activity of MPO were significantly decreased,and the plasma SOD activity was significantly increased in IPoC group and MT group as compared with I/R group(P<0.05 for all).The myocardial AI and the caspase-3 mRNA expression were lower and the bcl-2 mRNA expression was higher in IPoC and MT groups than those in I/R group(all P<0.05).It is concluded that the IPoC and MT can effectively reduce the I/R injury in the AS rabbits,and the mechanisms involved anti-oxidation,anti-inflammation,up-regulation of bcl-2 expression and down-regulation of caspase-3 expression.Minocycline can be used as an effective pharmacologic postconditioning drug to protect myocardia from I/R injury. 展开更多
关键词 MINOCYCLINE pharmacologic postconditioning ischemic postconditioning myocardial ischemia-reperfusion ATHEROSCLEROSIS
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Ischemic postconditioning protects against ischemic brain injury by up-regulation of acid-sensing ion channel 2a 被引量:5
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作者 Wang-sheng Duanmu Liu Cao +3 位作者 Jing-yu Chen Hong-fei Ge Rong Hu Hua Feng 《Neural Regeneration Research》 SCIE CAS CSCD 2016年第4期641-645,共5页
Ischemic postconditioning renders brain tissue tolerant to brain ischemia,thereby alleviating ischemic brain injury.However,the exact mechanism of action is still unclear.In this study,a rat model of global brain isch... Ischemic postconditioning renders brain tissue tolerant to brain ischemia,thereby alleviating ischemic brain injury.However,the exact mechanism of action is still unclear.In this study,a rat model of global brain ischemia was subjected to ischemic postconditioning treatment using the vessel occlusion method.After 2 hours of ischemia,the bilateral common carotid arteries were blocked immediately for 10 seconds and then perfused for 10 seconds.This procedure was repeated six times.Ischemic postconditioning was found to mitigate hippocampal CA1 neuronal damage in rats with brain ischemia,and up-regulate acid-sensing ion channel 2a expression at the m RNA and protein level.These findings suggest that ischemic postconditioning up-regulates acid-sensing ion channel 2a expression in the rat hippocampus after global brain ischemia,which promotes neuronal tolerance to ischemic brain injury. 展开更多
关键词 neural regeneration brain injury ischemic brain injury acid-sensing ion channels neuroprotection ischemic postconditioning neuroprotection protein expression neuronal density ischemic tolerance molecular mechanism gene expression nerve regeneration
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Spontaneous running wheel improves neuroprotection efficacy of ischemic postconditioning in mice following ischemia/reperfusion injury
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作者 Hong YE WeiWei Wang +10 位作者 Yu Ding XiaoLei Liu WenJI Jia WeiLi Luo HuiJuan Fan HongQun Zhou Jin Wang JianLong Ju DongMing Zhou TianHao Bao YuHong Zhu 《BIOCELL》 SCIE 2018年第3期79-85,共7页
Ischemic postconditioning(IP)has been shown to provide protection for ischemia/reperfusion(IR)injury,but its efficacy is limited.In this study we hypothesized that spontaneous running wheel(RW)could improve neuroprote... Ischemic postconditioning(IP)has been shown to provide protection for ischemia/reperfusion(IR)injury,but its efficacy is limited.In this study we hypothesized that spontaneous running wheel(RW)could improve neuroprotection efficacy of IP for IR.We established mouse models of IR and showed that compared to Sham group,IR group had obvious brain infract and neurological dysfunction.In IR+IP group,brain infract and neurological dysfunction improved compared to IR group.However,in IR+IP+RW group brain infract and neurological dysfunction improved much better.TUNEL assay showed that IP but not RW significantly reduced the number of apoptotic cells after IR.However,the number of apoptotic cells was significantly reduced in RW+IP group.In addition,the levels of pro-apoptotic factors increased in IR group but significantly reduced in IR+IP+RW group,while the levels of antiapoptotic factors decreased in IR group but significantly increased in IR+IP+RW group.Moreover,in IR+IP+RW group,MDA level was further decreased and SOD level was further increased compared to IR+IP group.Finally,both PI3K inhibitor and STAT3 inhibitor significantly worsened brain infract and neurological dysfunction and promoted apoptosis in IR mice.In conclusion,RW combined with IP reduces brain infract and neurological dysfunction in mice after IR,and this is associated with enhanced anti-apoptotic and anti-oxidant benefits via the activation of PI3K and STAT3 pathways. 展开更多
关键词 ischemic postconditioning ISCHEMIA/REPERFUSION running wheel apoptosis PI3K STAT3
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Influences of ischemic postconditioning at different positions on oxidative stress of myocardial ischemia-reperfusion injury in rats
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作者 Chao Wang Jian An +1 位作者 Xiao-Hong Li Ye Du 《Journal of Hainan Medical University》 2021年第6期1-4,共4页
Objective:To analyze the influences of locial ischemic postconditioning and remote limb ischemic postconditioning on oxidative stress response with myocardial ischemia reperfusion in rats.Methods:Thirty-two SD rats we... Objective:To analyze the influences of locial ischemic postconditioning and remote limb ischemic postconditioning on oxidative stress response with myocardial ischemia reperfusion in rats.Methods:Thirty-two SD rats were randomly divided into Sham group,ischemia/reperfusion(I/R)group,local ischemic postconditioning(LIPC)group,and remote limb ischemic postconditioning(RIPC)group,after 3 hourse reperfusion,the contents of serum creatinine kinase,MB isoenzyme(CK-MB),xanthine oxidase(XOD),superoxide dismutase(SOD),myeloperoxidase(MPO),tumor necrosis factor-α(TNF-α)were measured.The 2,3,5-triphenyltetrazolium chloride(TTC)staining was carried out to evaluate the area of myocardial infarction,cardiac function was evaluated by echocardiography,and HE staining was performed to observe the morphology of myocardial cells.Results:Compared with the Sham group,the SOD contents of the I/R group,LIPC group,RIPC group reduced significantly(P<0.05),the XOD,MPO,TNF-αcontents increased significantly(P<0.05);Compared with the I/R group,the TNF-αcontents of the LIPC group reduced significantly(P<0.05),other oxidative stress indicators of the LIPC group had no significant differences;Compared with the I/R group,the MPO and TNF-αcontents reduced(P<0.05),the SOD and XOD contents of the RIPC group had no significant differences;Compared with the LIPC group,the MPO contents reduced(P<0.05)in the RIPC group,other oxidative stress indicators had no significant differences.Compared with the Sham group,myocardial infarction area,CK-MB contents,LVIDs increased with the reduction of EF in I/R group,LIPC group,RIPC group(P<0.05),HE staining had differences;Compared with the I/R group,myocardial infarction area,CK-MB contents,LVIDd,LVIDs,EF and HE staining results had no significant differences in the LIPC group and the RIPC group;Compared with the RIPC group,the LIPC group had no significant differences.Conclusion:Remote limb ischemic postconditioning and local ischemic postconditioning can partially reduce the oxidative stress response,but does not significantly reduce myocardial infarction area,improve cardiac function. 展开更多
关键词 Ischemia reperfusion ischemic postconditioning Oxidative stress MYOCARDIUM
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NBP联合LIPostC对脑梗死患者神经功能及侧支循环的影响 被引量:1
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作者 李松 贺兴友 +3 位作者 汪波 詹彧 张杰 孙晶晶 《疑难病杂志》 CAS 2023年第9期909-913,918,共6页
目的观察丁苯酞(NBP)联合肢体缺血后适应(LIPostC)对脑梗死患者神经功能及侧支循环的影响。方法选取2020年10月—2022年10月浙江省人民医院毕节医院/毕节市第一人民医院神经内科诊治急性脑梗死患者252例,随机数字表法分为NBP组84例、LIP... 目的观察丁苯酞(NBP)联合肢体缺血后适应(LIPostC)对脑梗死患者神经功能及侧支循环的影响。方法选取2020年10月—2022年10月浙江省人民医院毕节医院/毕节市第一人民医院神经内科诊治急性脑梗死患者252例,随机数字表法分为NBP组84例、LIPostC组84例、NBP+LIPostC组(联合组)84例。NBP组应用丁苯酞氯化钠注射液,LIPostC组采用LIPostC干预,联合组采用丁苯酞氯化钠注射液联合LIPostC治疗,所有患者均治疗14 d。分别于治疗前及治疗后1 d、7 d、14 d通过基于CTA的区域软脑膜评分(rLMC)评估软脑膜侧支循环代偿情况,通过美国国立卫生研究院卒中量表(NIHSS)评估患者的神经功能,采用简易精神状态检查表(MMSE)评估患者的认知功能,采用日常生活活动(ADL)量表Barthel指数(BI)评分法和改良Rankin量表(mRS)评估患者的日常生活活动能力。比较3组患者3个月内病死率及不良事件发生率。结果治疗1、7、14 d后各组患者侧支循环代偿良好率、MMSE评分及BI评分均提高,NIHSS评分及mRS评分均降低,其中治疗1 d后3组患者组间比较差异无统计学意义(P>0.05),但治疗7、14 d后NIHSS、MMSE、BI及mRS评分3组比较差异具有统计学意义(7 d:F/P=35.811/0.001、86.735/0.001、36.652/0.001、236.965/0.001;14 d:F/P=85.593/0.001、154.507/0.001、75.932/0.001、419.197/0.001)。联合组患者3个月内病死率低于NBP组和LIPostC组(χ^(2)/P=6.300/0.043),3组其余不良事件发生率比较差异无统计学意义(P>0.05)。结论NBP联合LIPostC能显著提高脑梗死患者侧支循环代偿情况,同时有利于改善患者神经功能、认知功能及日常生活活动能力,进而降低患者病死率,提高远期预后及生活质量。 展开更多
关键词 脑梗死 丁苯酞 肢体缺血后适应 神经功能 侧支循环
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N-乙酰半胱氨酸联合缺血后处理减轻糖尿病小鼠心肌缺血再灌注后肺损伤的作用研究
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作者 李爱梅 吴建江 +1 位作者 姜巧巧 戴晓雯 《新疆医科大学学报》 CAS 2024年第1期1-5,13,共6页
目的研究N-乙酰半胱氨酸(NAC)联合缺血后处理(IPostC)对糖尿病小鼠心肌缺血再灌注后肺损伤的作用。方法选择15周龄雄性db/db糖尿病小鼠30只,分为假手术组(D-SO组,n=10)、心肌缺血/再灌注组(D-I/R组,n=10)和NAC联合缺血后处理组(D-NAC+IP... 目的研究N-乙酰半胱氨酸(NAC)联合缺血后处理(IPostC)对糖尿病小鼠心肌缺血再灌注后肺损伤的作用。方法选择15周龄雄性db/db糖尿病小鼠30只,分为假手术组(D-SO组,n=10)、心肌缺血/再灌注组(D-I/R组,n=10)和NAC联合缺血后处理组(D-NAC+IPostC组,n=10)。D-SO组小鼠开胸后不做任何处理;D-I/R组小鼠干预为冠状动脉左前降支结扎60 min,后复灌15 min。D-NAC+IPostC组在结扎冠状动脉左前降支前30 min腹腔注射NAC150 mg/kg,缺血后处理的干预方式为小鼠缺血60 min后即刻进行3个周期再灌注/缺血,然后再灌注15 min。于再灌注结束后颈动脉取血,检测血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-1(MCP-1)水平,处死小鼠,取肺组织,检测湿干重(W/D)比值,光镜下观察肺组织病理形态学变化,计算肺损伤评分,测定肺组织氧化应激相关标志物谷胱甘肽(GSH)、超氧化物歧化酶(SOD)及丙二醛(MDA)水平,采用Western Blot法检测肺组织缺氧诱导因子1α(HIF-1α)和血管内皮生长因子(VEGF)的表达水平。结果与D-SO组比较,D-I/R组小鼠光镜下病理学损伤严重(P<0.05),肺W/D比值增加(P<0.05),血清TNF-α、CRP水平降低(P<0.05),MCP-1水平升高(P<0.05),肺组织MDA含量增加(P<0.05),SOD及GSH活性降低(P<0.05),肺组织HIF-1α及VEGF表达上调(P<0.05)。与D-I/R组比较,D-NAC+IPostC组肺组织镜下病理学损伤明显减轻(P<0.05),肺W/D比值降低(P<0.05),血清TNF-α、MCP-1水平降低(P<0.05),CRP水平升高(P<0.05),肺组织氧化应激因子MDA含量降低(P<0.05),抗氧化应激因子SOD及GSH活性升高(P<0.05),肺组织HIF-1α、血管内皮生长因子(VEGF)水平表达增高(P<0.05)。结论NAC联合IPostC可减轻糖尿病心肌缺血再灌注小鼠肺损伤,其机制可能与HIF-1α/VEGF信号通路相关。 展开更多
关键词 心肌缺血再灌注 肺损伤 N-乙酰半胱氨酸 缺血后处理
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远隔缺血后适应对脑梗死患者临床疗效及脑保护作用的影响
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作者 陈艳洁 赵紫烨 +2 位作者 朱丽霞 周玉蕾 白鸽 《西部医学》 2024年第6期850-854,共5页
目的探讨远隔缺血后适应(RIPC)对脑梗死患者临床疗效、脑保护作用的影响。方法选取本院2022年1月—2022年12月收治的110例脑梗死患者,采用随机数字表法分为常规组(脑梗死常规治疗)和RIPC组(常规组治疗基础上+RIPC),每组55例。比较两组... 目的探讨远隔缺血后适应(RIPC)对脑梗死患者临床疗效、脑保护作用的影响。方法选取本院2022年1月—2022年12月收治的110例脑梗死患者,采用随机数字表法分为常规组(脑梗死常规治疗)和RIPC组(常规组治疗基础上+RIPC),每组55例。比较两组疗效及两组治疗前后神经功能评分、脑血流动力学指标[搏动指数(PI)和动脉平均血流速度(Vm)]、血清炎症因子[C反应蛋白(CRP)、白介素6(IL-6)和转化生长因子-β(TGF-β)]、胱抑素C(CysC)和血清尿酸(UA)水平,记录脑缺血症状再发生及不良反应发生情况。结果治疗6个月后,RIPC组总有效率显著高于常规组(P<0.05);治疗前两组美国国立卫生研究院卒中量表(NHISS)评分和Barthel评分比较差异无统计学意义(P>0.05),治疗6个月后两组NHISS评分均较治疗前降低,Barthel评分升高(均P<0.05),且RIPC组和常规组NHISS评分和Barthel评分比较差异有统计学意义(P<0.05)。治疗前两组Vm和PI比较差异无统计学意义(P>0.05),治疗6个月后两组Vm均较治疗前升高,PI均较治疗前降低(P<0.05),且RIPC组和常规组Vm和PI比较差异有统计学意义(P<0.05)。治疗前两组IL-6、CRP和TGF-β比较差异无统计学意义(P>0.05),治疗6个月后两组IL-6、CRP均较治疗前降低,TGF-β升高(均P<0.05),且RIPC组和常规组IL-6、CRP和TGF-β比较差异有统计学意义(P<0.05)。治疗前两组CysC及UA比较差异无统计学意义(P>0.05),治疗6个月后,两组CysC及UA均较治疗前降低(P<0.05),且RIPC组和常规组比较差异有统计学意义(P<0.05);两组间脑缺血症状再发生及不良反应比较差异无统计学意义(P>0.05)。结论RIPC对脑梗死患者临床效果肯定,可发挥较好脑保护作用,有效改善患者神经功能和炎症反应,调节机体UA及CysC水平,且安全有效,值得临床推广应用。 展开更多
关键词 远隔缺血后适应 脑梗死 疗效 脑保护作用
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远隔缺血后适应治疗对急性缺血性卒中超时间窗患者临床预后的影响:一项随机对照试验
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作者 袁丹 王莹 +4 位作者 王英鹏 许莉 薛佳 程晶晶 王海鹏 《中国全科医学》 CAS 北大核心 2025年第2期169-174,共6页
背景急性缺血性卒中(AIS)高发,及时恢复脑血流是治疗的关键,超时间窗就诊患者无更多促进脑血流恢复的治疗手段。研究远隔缺血后适应(RIPostC)治疗对AIS超时间窗就诊患者的临床疗效、并发症和预后,具有重要的临床意义。目的探究RIPostC... 背景急性缺血性卒中(AIS)高发,及时恢复脑血流是治疗的关键,超时间窗就诊患者无更多促进脑血流恢复的治疗手段。研究远隔缺血后适应(RIPostC)治疗对AIS超时间窗就诊患者的临床疗效、并发症和预后,具有重要的临床意义。目的探究RIPostC治疗对AIS超时间窗患者干预的影响,为超时间窗就诊的AIS患者寻求安全、有效的脑血流恢复治疗方式。方法本研究采用随机、分组、安慰剂对照法进行试验。选取2021-09-02—2022-08-31于北京航天总医院神经内科病房住院治疗的超溶栓时间窗(发病时间>6 h)的AIS患者为研究对象。依据随机数字表法将患者分为对照组和试验组。试验期+随访期共90 d,均使用同等的一般治疗、脑血管病常规治疗,试验组在此基础上给予RIPostC治疗14 d(28次),对照组给予模拟的RIPostC治疗14 d(28次)。在干预前和干预后30 d、干预后90 d,采用改良Rankin量表(mRS)、美国国立卫生研究院卒中量表(NIHSS)评估两组患者神经功能,简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评估患者认知功能,工具性日常生活能力量表(IADL)评估日常生活能力,焦虑自评量表(SAS)、抑郁自评量表(SDS)评估精神状态,经颅多普勒超声(TCD)评估脑血流速度,以白介素(IL)-6反映炎症情况。结果122例患者中,最终完成试验及随访99例,其中试验组49例,对照组50例。两组患者性别、年龄、基础疾病(高血压、糖尿病、冠心病)及基线NIHSS评分比较,差异无统计学意义(P>0.05)。重复测量方差分析结果示,时间与组别对MMSE、MoCA、mRS、NIHSS、脑血流速度、IL-6存在交互作用(P<0.05),时间和组别对MMSE、MoCA、NIHSS、脑血流速度、IL-6主效应显著(P<0.05),时间对mRS、SAS、SDS、IADL主效应显著(P<0.05)。试验组干预后30、90 d MMSE、MoCA评分及脑血流速度均高于对照组,mRS、NIHSS评分均低于对照组(P<0.05);试验组干预后30、90 d SDS、IADL评分低于对照组(P<0.05);试验组干预后30 d SAS评分高于对照组,IL-6低于对照组(P<0.05)。99例患者中共有23例患者发生不良反应,其中试验组17例,对照组6例,两组皮肤瘀点、头晕、心慌、胸闷发生率比较,差异无统计学意义(P>0.05);对照组患者皮肤瘀斑发生率[4.00%(2/50)与12.24%(6/49)]、总不良反应发生率[12.00%(6/50)与34.69%(17/49)]低于试验组(P<0.05)。结论RIPostC治疗可降低AIS患者的炎症反应,对神经功能、认知功能抑郁情绪及颅内血流速度可起到积极的改善效果。 展开更多
关键词 急性缺血性卒中 远隔缺血后适应 超时间窗 炎症反应 随机对照试验 重复测量方差分析
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缺血后处理对心肌缺血再灌注大鼠心功能、心肌细胞凋亡和心肌组织线粒体凋亡相关分子表达的影响
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作者 王涛 郝恩刚 《医学分子生物学杂志》 CAS 2024年第6期586-590,596,共6页
目的分析缺血后处理(ischemic postconditioning,IP)对心肌缺血再灌注(ischemia-reperfusion,IR)大鼠心功能、心肌细胞凋亡和心肌组织线粒体凋亡相关分子表达的影响。方法将40只8周龄雄性SD大鼠分笼喂养,每笼5只,适应性饲养7 d,随机分... 目的分析缺血后处理(ischemic postconditioning,IP)对心肌缺血再灌注(ischemia-reperfusion,IR)大鼠心功能、心肌细胞凋亡和心肌组织线粒体凋亡相关分子表达的影响。方法将40只8周龄雄性SD大鼠分笼喂养,每笼5只,适应性饲养7 d,随机分为空白对照组(对照组)、假手术组(S组)、心肌IR造模组(IR组)、心肌IP造模+IP处理组(IP组),每组各10只。术后4 h使用生物机能实验系统记录大鼠心功能[左心室收缩压(left ventricular systolic pressure,LVSP)、心室舒张末压(left ventricular enddiastolic pressure,LVEDP)、左心室压变化速率最大值(±dp/dtmax)]。采用TUNEL法检测心肌细胞凋亡指数,采用RT-PCR法检测心肌细胞凋亡相关蛋白BCL-2、BAX及天冬氨酸特异性半胱氨酸蛋白酶-3(cysteinylaspartate-specific proteinase 3,Caspase-3)、法尼酯衍生物X受体(farnesyl X receptor,FXR)、小异二聚体配体(small heterodimer partner,SHP)相对表达量。蛋白质印迹法检测心肌细胞线粒体凋亡通路标志物细胞色素C(cytochrome C,Cyt-C)的释放量。结果IP组及IR组LVEDP、心肌细胞凋亡指数、心肌组织BAX、CASPASE-3、FXR、SHP相对表达量及心肌细胞胞浆Cyt-C蛋白灰度值均高于S组、对照组(P<0.05),IR组LVEDP、心肌细胞凋亡指数、BAX、CASPASE-3、FXR、SHP相对表达量及Cyt-C蛋白灰度值高于IP组(P<0.05);IP组及IR组LVSP、±dp/dtmax、心肌组织BCL-2相对表达量均低于S组、对照组(P<0.05),IR组LVSP、±dp/dtmax、心肌组织BCL-2相对表达量均低于IP组(P<0.05)。结论IP处理可减轻大鼠心肌IR损伤,改善心功能,可能与调控BCL-2/BAX、FXR/SHP等凋亡相关信号蛋白的表达有关。 展开更多
关键词 心肌缺血再灌注 缺血后处理 心肌细胞凋亡 心肌细胞线粒体凋亡 心功能
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双下肢缺血后处理保护再灌注心肌时效性及对线粒体通路调控的研究
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作者 邢大一 张涌 +4 位作者 李毅 梁法禹 王志斌 郭林静 秦东泽 《中国病理生理杂志》 CAS CSCD 北大核心 2024年第4期637-645,共9页
目的:观察双下肢缺血后处理(即远隔器官缺血后处理,remote ischemic postconditioning,RIpostC)保护缺血再灌注小鼠心肌的时效性及对心肌线粒体依赖性凋亡和坏死通路的调控。方法:成年雄性C57BL/6J野生型小鼠被随机分为假手术(sham)组... 目的:观察双下肢缺血后处理(即远隔器官缺血后处理,remote ischemic postconditioning,RIpostC)保护缺血再灌注小鼠心肌的时效性及对心肌线粒体依赖性凋亡和坏死通路的调控。方法:成年雄性C57BL/6J野生型小鼠被随机分为假手术(sham)组、心肌缺血再灌注(myocardial ischemia/reperfusion,MI/R)组、缺血后处理组、RIpostC组及RIpostC延迟1、5、10、15、30和60 min组。阻断左冠脉45 min,再灌注24 h,建立MI/R模型;气囊袖带阻断双下肢血流5 min,再灌注5 min,实施RIpostC。再灌注24 h后,Evans blue和TTC染色观察心肌梗死面积与血清心肌钙蛋白I变化。TUNEL和高迁移率族盒蛋白1(high mobility group box protein 1,HMGB1)染色观察心肌凋亡和坏死;线粒体水肿实验观察心肌线粒体膜电位变化;Western blot观察心肌细胞凋亡和线粒体膜通透性转换孔(mitochondrial permeability transition pore,mPTP)相关蛋白表达。结果:与MI/R组比较,RIpostC及RIpostC延迟1、5、10和15 min组心肌梗死面积明显减少,RIpostC延迟30和60 min组则无明显改变。缺血后处理与RIpostC对缺血再灌注心肌有类似保护效应。RIpostC减少缺血再灌注心肌细胞凋亡和坏死发生。RIpostC降低缺血再灌注心肌亲环蛋白D(cyclophilin D,CypD)、Bax和Bak蛋白表达水平。结论:心肌再灌注后15 min内实施RIpostC能够减少心肌梗死面积,其保护作用与缺血后处理类似;RIpostC通过调控线粒体依赖性凋亡和坏死通路减轻MI/R损伤。 展开更多
关键词 心肌缺血 再灌注损伤 远隔器官缺血后处理 细胞凋亡 坏死 线粒体膜通透性转换孔
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尼可地尔联合缺血后适应对STEMI患者急诊PPCI心肌血流灌注及预后的影响
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作者 卜云涛 丁超 +2 位作者 刘文秀 王刚 程锦浩 《中南医学科学杂志》 CAS 2024年第4期628-631,共4页
目的观察尼可地尔联合缺血后适应(MIP)对急性ST段抬高心肌梗死(STEMI)患者急诊直接经皮冠脉介入术(PPCI)心肌血流灌注及预后的影响。方法选取急诊行PPCI的STEMI患者200例,随机均分为对照组(PPCI)、尼可地尔组(PPCI+尼可地尔)、MIP组(PPC... 目的观察尼可地尔联合缺血后适应(MIP)对急性ST段抬高心肌梗死(STEMI)患者急诊直接经皮冠脉介入术(PPCI)心肌血流灌注及预后的影响。方法选取急诊行PPCI的STEMI患者200例,随机均分为对照组(PPCI)、尼可地尔组(PPCI+尼可地尔)、MIP组(PPCI+MIP)、联合组(PPCI+尼可地尔+MIP)。比较4组患者心肌血流灌注恢复、心肌损伤、心功能和预后的差异。结果与对照组比较,尼可地尔组、MIP组及联合组术后即刻TIMI血流帧数、术后24 h肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)、术后72 h cTnI降低,尼可地尔组及联合组术后无复流发生率降低,联合组术后12个月N末端B型脑钠肽前体、术后7天心律失常严重程度评分、12个月内心衰和心绞痛再住院率降低,尼可地尔组及联合组术后2 h ST段回落率升高(P<0.05)。联合组术后24 h CK-MB显著低于尼可地尔组(P<0.05)。结论尼可地尔联合MIP在心肌血流灌注恢复、降低心肌损伤及改善患者预后方面的效果值得肯定。 展开更多
关键词 STEMI 尼可地尔 心肌缺血后适应 经皮冠脉介入术
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七氟烷后处理对大鼠脑缺血再灌注损伤保护作用的研究
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作者 毛艺锟 王士雷 +2 位作者 吴秀云 赵芹 李瑜 《精准医学杂志》 2024年第2期125-129,133,共6页
目的探讨七氟烷后处理对大鼠脑缺血再灌注(I/R)损伤的保护作用及其机制。方法选择SPF级成年健康雄性SD大鼠80只,随机分为假手术组(S组)、脑缺血再灌注组(I/R组)、脑I/R+七氟烷后处理组(ISP组)、脑I/R+七氟烷后处理+核因子E2相关因子2(Nr... 目的探讨七氟烷后处理对大鼠脑缺血再灌注(I/R)损伤的保护作用及其机制。方法选择SPF级成年健康雄性SD大鼠80只,随机分为假手术组(S组)、脑缺血再灌注组(I/R组)、脑I/R+七氟烷后处理组(ISP组)、脑I/R+七氟烷后处理+核因子E2相关因子2(Nrf2)抑制剂组(ISPB组),每组20只。除S组外,其余组大鼠均用线栓法闭塞大脑中动脉2 h并再灌注24 h的方法制备脑I/R损伤大鼠模型(S组大鼠只在大脑中动脉下穿线不结扎)。ISP组大鼠于再灌注即刻吸入3%七氟烷30 min,ISPB组在缺血前30 min腹腔注射Nrf2抑制剂鸦胆子苦醇(2 mg/kg),其余处理同ISP组。建模成功后通过神经功能评分评估各组大鼠神经功能损害程度。随后获取大鼠左心室血及脑组织病理切片,以2,3,5-氯化三苯基四氮唑(TTC)染色测定各组大鼠脑梗死体积百分比,采用酶联免疫吸附试验检测大鼠血清中炎症因子白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)和氧化应激相关因子丙二醛(MDA)及超氧化物歧化酶(SOD)水平,采用免疫印迹实验检测大鼠脑组织中凋亡相关蛋白B细胞淋巴瘤-2(Bcl-2)、Bcl-2相关联x(Bax)、半胱胺酸天冬氨酸蛋白酶-3(Caspase-3)及Nrf2信号通路相关蛋白Nrf2和血红素加氧酶1(HO-1)表达,采用免疫荧光实验检测大鼠脑组织细胞核内外Nrf2表达。结果与I/R组相比,ISP组大鼠神经功能缺损评分、脑梗死体积百分比,以及血清IL-1β、TNF-α、MDA水平和脑组织总蛋白Bax、Caspase-3水平均下降(t=5.76~18.39,P<0.05);血清中SOD水平及脑组织总蛋白Nrf2、HO-1、Bcl-2水平均升高(t=5.73~14.08,P<0.05),Nrf2免疫荧光强度增强。与ISP组相比,ISPB组神经功能缺损评分、脑梗死体积百分比,以及血清中IL-1β、TNF-α、MDA水平和脑组织总蛋白Bax、Caspase-3水平均升高(t=3.06~8.19,P<0.05);血清中SOD水平和脑组织总蛋白Nrf2、HO-1、Bcl-2水平均下降(t=2.67~9.01,P<0.05),Nrf2免疫荧光强度减弱。结论七氟烷后处理可以通过激活Nrf2信号通路抑制氧化应激、炎症反应和细胞凋亡,减轻大鼠脑I/R损伤。 展开更多
关键词 七氟烷 缺血后处理 脑缺血 再灌注损伤 NF-E2相关因子2 信号传导 大鼠 Sprague-Dawley
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缺血后适应对急性ST段抬高型心肌梗死患者PCI介入术后缺血-再灌注损伤的预后影响 被引量:1
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作者 沈小梅 田小晶 单红英 《川北医学院学报》 CAS 2024年第2期182-185,共4页
目的:观察缺血后适应(IPoC)对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)后缺血-再灌注损伤(IRI)预后影响。方法:将90例STMEI患者按照不同治疗方式分为对照组(常规方法行PCI)和观察组(再灌注开始1 min内行IPoC),每组各4... 目的:观察缺血后适应(IPoC)对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)后缺血-再灌注损伤(IRI)预后影响。方法:将90例STMEI患者按照不同治疗方式分为对照组(常规方法行PCI)和观察组(再灌注开始1 min内行IPoC),每组各45例。比较两组患者ST段回落情况,心肌再灌注评价,心肌坏死标志物,心功能指标,外周血氨基末端B型钠尿肽原(NT-proBNP)、超敏C反应蛋白(hs-CRP)、内皮素1(ET-1)和主要心脏不良事件。结果:观察组患者术后6 h完全回落高于术后2 h(P<0.05);术后心肌再灌注评价指标CTFC和WMSI,心肌坏死标志物c-TnI、CK和CK-MB,外周血NT-proBNP、hs-CRP和ET-1水平均低于对照组(P<0.05);主要心脏不良事件发生率低于对照组(P<0.05)。结论:IPoC能有效改善STMEI患者PCI介入后IRI,能降低心肌酶和NT-proBNP、hs-CRP和ET-1水平,改善预后,值得临床应用推广。 展开更多
关键词 缺血后适应 经皮冠状动脉介入术 急性ST段抬高型心肌梗死 缺血-再灌注损伤
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肢体远隔缺血预处理联合远隔缺血后处理对胸腔镜肺切除术肺损伤的影响
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作者 王彦珍 高昌俊 +3 位作者 郑兰兰 郭飞 刘晨 韩瑞丽 《空军军医大学学报》 CAS 2024年第10期1171-1177,共7页
目的观察肢体远隔缺血预处理(RIPC)联合远隔缺血后处理(RIPostC)对胸腔镜肺切除术后肺损伤以及术后肺部并发症(PPCs)的影响。方法纳入择期行胸腔镜肺切除术患者150例,根据随机数字表法分为两组,T组和C组,每组75例。T组于单肺通气(OLV)... 目的观察肢体远隔缺血预处理(RIPC)联合远隔缺血后处理(RIPostC)对胸腔镜肺切除术后肺损伤以及术后肺部并发症(PPCs)的影响。方法纳入择期行胸腔镜肺切除术患者150例,根据随机数字表法分为两组,T组和C组,每组75例。T组于单肺通气(OLV)前和恢复双肺通气时将止血带绑于一侧上臂,实施5 min缺血/5 min再灌注3个循环的缺血预处理和后处理。采集两组患者麻醉诱导前、OLV 30 min、OLV 1 h、双肺通气后20 min、术后6 h、术后24 h时非缺血处理侧桡动脉血样,通过血气分析并记录吸入氧浓度来计算患者相应时点的氧合指数(PaO_(2)/FiO_(2))、肺泡-动脉氧分压差(A-aDO_(2))以及呼吸指数(RI)。记录机械通气相关参数,计算动态顺应性、静态顺应性以及驱动压。测定T_(1)~T_(6)时血浆TNF-α、IL-6、IL-10浓度,并统计患者住院期间肺部并发症及平均住院日情况。结果两组患者在T_(2)~T_(6)时PaO_(2)/FiO_(2)低于T_(1)、A-aDO_(2)高于T_(1)(P<0.05),与C组比较,T组于T_(3)、T_(5)时PaO_(2)/FiO_(2)升高、A-aDO_(2)降低(P<0.05)。两组患者RI于T_(2)~T_(6)时高于T_(1)(P<0.05),T组RI于T_(2)、T_(3)、T_(5)时低于C组(P<0.05)。两组患者血浆IL-6、IL-10、TNF-α浓度在各时点无统计学意义(P>0.05)。T组术后24 h急性肺损伤发生率以及术后住院时间均低于C组(P<0.05)。与C组比较,OLV后30 min和1 h时T组动态顺应性和静态顺应性升高(P<0.05)。两组患者驱动压于T_(2)~T_(4)时高于T_(1)(P<0.05),T组驱动压于T_(2)、T_(3)时低于C组(P<0.05)。结论肢体RIPC联合RIPostC能改善胸腔镜肺切除术围术期氧合,减轻肺损伤,减少PPCs。 展开更多
关键词 肢体远隔缺血预处理 肢体远隔缺血后处理 单肺通气 肺切除术 肺损伤
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