MindMap Gallery Chapter 12 Ischemia-reperfusion injury
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Edited at 2024-10-13 15:35:58Ceci est le chapitre 5 du livre de l'enseignant "This Is Auth to Read", qui parle principalement de ces aspects: ① L'importance de la capacité d'apprentissage ②Comment ajouter un contexte à l'information ③Comment distinguer les connaissances et les informations Je ne vous précipite pas pour remettre en question et défier ⑤Comment utiliser des notes collantes pour mettre à niveau votre capacité d'apprentissage ⑥Pour pourquoi chasser les "biens secs" un pseudo-apprentissage?
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Ceci est le chapitre 5 du livre de l'enseignant "This Is Auth to Read", qui parle principalement de ces aspects: ① L'importance de la capacité d'apprentissage ②Comment ajouter un contexte à l'information ③Comment distinguer les connaissances et les informations Je ne vous précipite pas pour remettre en question et défier ⑤Comment utiliser des notes collantes pour mettre à niveau votre capacité d'apprentissage ⑥Pour pourquoi chasser les "biens secs" un pseudo-apprentissage?
Afin d'aider tout le monde à utiliser Deepseek plus efficacement, une collection de Mind Map Deepseek Guide a été spécialement compilée! Cette carte mentale résume le contenu principal: liens liés à Yitu, analyse de profil DS, comparaison des routes technologiques Deepseek et ChatGpt, Guide de déploiement du modèle Deepseek et Qwen, comment gagner plus d'argent avec Deepseek, comment jouer Deepseek, Deepseek Scientific Research Applications Mows Inside Attendez, vous permettant de saisir rapidement l'essence de l'interaction AI. Qu'il s'agisse de la création de contenu, de la planification du plan, de la génération de code ou de l'amélioration de l'apprentissage, Deepseek peut vous aider à atteindre deux fois le résultat avec la moitié de l'effort!
Il s'agit d'une carte mentale sur les 30 instructions de niveau d'alimentation de Deepseek.
Chapter 12 Ischemia-reperfusion injury
concept
After blood perfusion is restored to ischemic tissues and organs, the original damage is not alleviated, but instead aggravates their dysfunction and structural damage.
reasons and conditions
reason
Restoring blood supply after systemic circulatory disorder
Unblocking microcirculation during shock
Cardiopulmonary and cerebral resuscitation after cardiac arrest
Restoration of blood flow after tissue and organ ischemia
Replantation of severed limb
organ transplant
After cardiopulmonary bypass
Single vessel recanalization surgery
coronary antispasmodic
Thrombolytic therapy
coronary artery bypass grafting
Percutaneous Transluminal Coronary Angioplasty (PTCA)
condition
length of ischemia time
Time is too short
Less prone to IRI
Restoring organ blood perfusion as early as possible is the most important treatment strategy for preventing and treating IRI
too long
tissue necrosis
IRI will not occur
Functional status of organs before ischemia
collateral circulation
Organs that are prone to collateral circulation are less likely to develop IRI
oxygen demand
Organs with a high demand for foreign energy are prone to IRI
Perfusate conditions during reperfusion
Oxygen abnormality
Hypoxic perfusion/hypoxic culture
reoxygenation
Injury worsens
Calcium abnormality
Calcium-free fluid perfusion
Calcium solution
myocardial damage
Abnormal pH
reperfusion acid correction
Injury worsens
Low pressure, low temperature, low pH, low sodium, low calcium
Reduce reperfusion injury
High pressure, high temperature, high pH, high sodium, high calcium
Aggravate reperfusion injury
Mechanism
Increased free radicals
free radicals
Definition: A general term for atoms, atomic groups or molecules that contain a single unpaired electron in the outer electron orbit.
Free radical species
Oxygen free radicals (95%)
superoxide anion radical
It is the basis for the production of other free radicals and reactive oxygen species
hydroxyl radical
The highest content
Account for 80%
most active
The most toxic
damage DNA
Lipoxy radicals
nitric oxide free radical
other
Accept electrons and products
O2 accepts 1 electron to form O2- O2 accepts 2 electrons to form H2O2 O2 accepts an electron to form OH • O2 accepts 4 electrons to form H2O
non-oxygen free radicals
Cl-, CH3-, H-
Under physiological conditions, 1-2% oxygen will generate oxygen free radicals
Clear method
antioxidant enzymes
Superoxide dismutase (SOD)
catalase
Glutathione peroxidase (GSH-Px)
non-enzymatic antioxidants
Vit C, E, beta-carotene, coenzyme Q
Reduced glutathione (GSH)
Under pathological conditions, excessive free radical production or insufficient antioxidant capacity of the body can trigger oxidative stress and lead to cell damage.
increase mechanism
Ischemia and hypoxia
Hypoxanthine accumulates in ischemic areas
Increased production of xanthine oxidase
Catalyzes the oxidation of hypoxanthine and xanthine
Chemokines cause neutrophils to migrate to ischemic tissue and infiltrate
neutrophil respiratory burst
NADH/NADPH is oxidized
Sympathoadrenal medullary excitement
Catecholamine autooxidation
Monoamine oxidase oxidative decomposition
Losing electrons
Provides large amounts of oxygen as electron acceptor during reperfusion
Increased production of reactive oxygen species
mitochondrial damage
ATP decrease
Calcium overload: increased calcium uptake by mitochondria
Mitochondrial cytochrome oxidase is inhibited
Mitochondria are reduced by monotons Increased production of free radicals
Decreased antioxidant enzyme activity
Reduce free radical scavenging
free radical damage
Attack biofilms
lipid peroxidation
oxidatively damaged proteins
Oxidative damage to DNA
Mainly OH-
calcium overload
definition
Various reasons cause abnormalities in the calcium transport mechanism and abnormal increase in intracellular calcium ions, leading to cell structure damage and functional and metabolic disorders.
mechanism
Enhanced sodium-calcium exchanger antiport transport (primary mechanism
Mechanisms that trigger reperfusion injury
Increased calcium uptake by mitochondria
Activate calcium ion-dependent degradative enzymes
Promote the generation of oxygen free radicals
reperfusion arrhythmia
Enhanced sodium-calcium exchange
Generate transient sodium ion inward current
late depolarization
Common ventricular arrhythmias in myocardial IRI
Excessive activation of inflammatory response (white blood cell aggregation and infiltration)
Capillary no-reflow phenomenon
White blood cells roll and adhere to wall
Block microcirculation
tissue ischemia and hypoxia
release free radicals
Releases proteolytic enzymes and pro-inflammatory factors
Functional metabolic changes
myocardium
reperfusion arrhythmia
Mainly ventricular arrhythmias
ventricular tachycardia
ventricular fibrillation
myocardial stunning
The phenomenon that the ischemic myocardial blood flow is still in a "low-function state" for a period of time after the blood flow is restored, and it often takes hours or days to return to normal myocardial diastolic and contraction function, is called myocardial stunning.
brain
morphology
Cerebral edema, brain cell necrosis
electroencephalogram
pathological slow wave
clinical manifestations
After ischemia-reperfusion, severe impairment of sensation, movement, and consciousness
Prevention and control
1. Reduce ischemic damage and control reperfusion conditions
Restore blood flow as soon as possible
Low pressure, hypothermia, hypoxia, low calcium, low sodium perfusion solution
2. Improve metabolism of ischemic tissue
3. Scavenge free radicals
4. Reduce calcium overload: calcium antagonists
5. Application of neutrophil inhibitors and cytoprotective agents
6. Supplement ATP
7. Ischemic preconditioning and ischemic postconditioning