脂肪细胞分泌的炎症因子及相关信号通路介导的肥胖和胰岛素抵抗

脂肪组织是机体能量的储存库,也是分泌一系列激素和促炎因子的内分泌器官。在肥胖个体中,脂肪细胞能分泌多种炎症因子,促进巨噬细胞浸润,并通过激活多种炎症相关信号通路,引起脂肪组织中炎症水平增加和胰岛素受体底物1丝氨酸磷酸化,并最终导致胰岛素抵抗的发生。临床研究发现二甲双胍和非甾体类抗炎药等对肥胖诱导的胰岛素抵抗有一定改善作用。本文综述了脂肪来源的炎症因子及其相关的信号通路与肥胖和胰岛素发生发展的关系,并对其预防和治疗策略予以展望。     

下丘脑神经肽在中枢能量代谢方面的调节作用

下丘脑作为调控能量稳态的中枢，在维持机体能量代谢平衡方面发挥重要作用，通过下丘脑弓状核内神经肽Y、Agouti相关蛋白、阿黑皮素原及甘丙肽之间相互作用形成的调节网络控制能量摄入及消耗，维持代谢稳态。但调控网络上任何一个环节产生异常都有可能导致机体能量调节紊乱，最终导致肥胖症。该文主要综述了下丘脑神经肽在中枢能量代谢方面的调控作用，为将来干预和治疗肥胖等内分泌疾病提供依据。     

脂联素转录和翻译机制的研究进展

脂联素是由脂肪细胞分泌的脂肪因子,在胰岛素抵抗、抗动脉粥样硬化和抗炎症方面都发挥了重要的作用。在血液循环中脂联素以三聚体、六聚体和高分子量多聚体3种形式存在,不同的聚化物形式在调控能量平衡方面的作用不同。调控脂联素转录、翻译、多聚化和分泌的相关机制研究可为治疗胰岛素抵抗、2型糖尿病和与肥胖相关的其他代谢疾病提供新的治疗靶点。     

下丘脑调控肝葡萄糖生成及胰岛素抵抗

人、啮齿类及多种哺乳动物的肥胖和胰岛素抵抗（IR）相关。IR及伴随的代谢综合征（MS）常增加心血管死亡率及导致2型糖尿病（T2DM）的发生。下丘脑对调节摄食及营养素具有重要作用。近又发现脑（尤其是下丘脑）可调控激素,如可调控胰岛素、     

多囊卵巢综合征与胰岛素抵抗和多种脂肪细胞因子的关系

多囊卵巢综合征(PCOS)是育龄期女性常见的内分泌代谢性疾病,目前认为主要与内分泌功能紊乱、下丘脑-垂体-卵巢轴调节功能异常、高胰岛素血症和胰岛素抵抗(IR)、肾上腺内分泌功能异常有关。脂肪组织不仅具有调节能量储存作用,同时还是一个内分泌器官,可分泌各种脂肪细胞因子,如脂联素、瘦素、内脂素、抵抗素、Chemerin等,这些因子通过其表达的增强或减弱不同层面参与机体内分泌代谢过程,包括能量代谢、胰岛素作用及脂类代谢等的调节,并参与肥胖、IR、血压及炎症等疾病的发生。     

一氧化碳与代谢综合征的研究进展

代谢综合征是以胰岛素抵抗为病理生理基础,胰岛素抵抗的发生与机体各种炎症因子干扰或阻断胰岛素信息传导通路有关.一氧化碳是一种重要的生物信号调控分子,可能具有抑制各种炎症因子释放,调节胰岛素敏感性的功能.本文就一氧化碳与代谢综合征的相互关系作一综述.     

骨形态发生蛋白7与肥胖关系的研究进展

肥胖是冠心病、高血压、2型糖尿病、高脂血症等许多代谢性疾病的共同危险因子,与胰岛素抵抗、代谢综合征密切相关。骨形态发生蛋白7(BMP-7)是最近发现的与肥胖相关的一种活性因子,可以特异性地激活棕色脂肪调控因子的表达,通过促进棕色脂肪细胞的分化来调控体内能量平衡。因此,对BMP-7的深入研究,了解其在肥胖的生理和病理过程中的作用,有助于揭示上述多基因疾病的分子生物学机制。     

11β-羟基类固醇脱氢酶1在炎症调控中的作用

11β-羟基类固醇脱氢酶(11β-HSD)是调节糖皮质激素(GC)作用的关键酶。11β-HSD有两个同工酶:11β-HSD1和11β-HSD2,催化具有活性的皮质醇与无活性的可的松之间的相互转化。1βl-HSD1主要表达于GC的靶器官,如肝脏、肺、脂肪组织、卵巢、脑组织等,在体内主要作为还原酶起作用,催化可的松还原为皮质醇。11β-HSD1在下丘脑-垂体-肾上腺轴及代谢综合征、肥胖、胰岛素抵抗、炎症调控等众多领域中有重要作用。11β-HSD1的作用越来越受到重视,现阐述11β-HSD1在炎症调控中的意义。     

下丘脑炎症和肥胖发病机制

肥胖及其相关的代谢和心血管并发症是欧美国家和高速发展中的中国面临的最具挑战的健康问题。因为肥胖十分的普遍,而且肥胖与代谢综合征和2型糖尿病紧密相关,影响着这些国家三分之一以上的成年人,治疗起来更挑战性。有效肥胖治疗的主要障碍是通常的减肥方法往往难以及时有成效。虽然我们目前还不完全理解减肥后体重再反弹的内在机制,但大量文献表明,体内脂肪储存受到神经体液的稳态调节,这一过程存在于肥胖者同时也存在于体重正常的人,这种神经-内分泌的稳态调节机制可能是体重反弹的重要机理。从炎症的角度来看,肥胖可以被看作是一种慢性炎性疾病,体脂的增加使生物体内的炎性介质升高,生物防御水平降低,特别是下丘脑饮食调节中枢的慢性炎症。最近的研究表明,在下丘脑关键区域的炎症控制,可以控制体重就是这一过程。因此,在该篇综述中,我们提出了生物过程能量平衡-是体内脂肪控制的基础,并提出了这个能量平衡调节系统中的某些缺陷导致肥胖发病的证据。然后,我们解决肥胖的发病机制,其次是有证据表明高脂肪的饮食(HFD)与控制着能量平衡的下丘脑关键区域的神经病理改变有关。最后,我们考虑如何交互作用会导致这种下丘脑炎症,以及这些交互作用对于肥胖发病机制的影响。     

食欲素与血糖和能量代谢的调节

食欲素是一种下丘脑兴奋性神经肽,参与调节睡眠、进食、自主神经功能等,并且在血糖稳态调控和能量代谢平衡中也扮演重要角色。食欲素表达神经元整合外周代谢信号,通过食欲素受体(OXR)1和OXR2发挥生理功能。另外,食欲素通过调节胰岛素和瘦素敏感性影响整体糖代谢,尤其是OXR2介导的信号通路可提高瘦素敏感性,从而预防食源性肥胖和胰岛素抵抗。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.