心室重塑患者瘦素抵抗与胰岛素抵抗及其相关性研究

目的:探讨不同基础病因的心室重塑患者血浆瘦素、可溶性瘦素受体水平的改变及其与胰岛素抵抗的关系.方法:选择心室重塑患者(心室重塑组,η=180)和体检正常者(对照组,η=60)采用酶联免疫吸附法测定血浆瘦素及可溶性瘦素受体、空腹胰岛素的浓度,同时常规测空腹血糖、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、体重指数、腰臀比等指标.采用彩色多普勒超声诊断仪测量心室重塑患者左心室舒张末期间隔厚度、左心室后壁厚度、左心室舒张末期内径及左心室射血分数值,计算左心室质量指数.结果:心室重塑组血浆瘦素、空腹胰岛素均高于对照组[(12.22±6.10)ng/ml vs(8.89±5.27)ng/ml,P<0.01];[(14.37±7.19)ng/ml vs(10.48±5.17)ng/ml,P<0.01],可溶性瘦素受体水平低于对照组[(124.08±62.12)ng/ml v8(164.23±69.60)ng/ml,P<0.01],差异均有统计学显著意义;其中缺血性心肌病患者血浆瘦素和空腹胰岛素水平最高,较高血压性心脏病和扩张型心肌病患者差异有统计学显著意义(P<0.01).可溶性瘦素受体呈现相反的变化,以对照组最高,其次为扩张型心肌病、高血压性心脏病和缺血性心肌病患者.结论:心室重塑患者存在高胰岛素血症和胰岛素抵抗.瘦素抵抗和胰岛素抵抗与心室重塑密切相关.     

冠心病及心肌梗塞患者血清甲状腺激素水平的变化及临床意义

本文报道了1988年6月至1988年12月,用放射免疫法测定35例冠心病(CHD)和9例心肌梗塞(MI)患者血清T_3、T_4含量。结果表明,CHD组血清T_3为1.29±0.33ng/ml,T_4为109±29ng/ml,二者均值处于正常范围。MI组血清T_3为1.00±0.18ng/ml,与CHD组血清T_3值相比差异显著(P<0.05);血清T_4为76±19ng/ml,明显低于MI组(P<0.01)。将两组按性别分     

老年高血清地高辛浓度患者地高辛中毒临床特点及对策

对血清地高辛浓度(SDC)>2.0ng/ml的36例老年患者与23例非老年患者进行对照研究。发现老年组易发生传导阻滞(30.6％vs 8.7％,P<0.05),但地高辛摄入量低于非老年组且变异大(172.91±103.43μg/d vs 234.55±61.99μg/d,P<0.01);多元逐步回归分析显示老年中毒受多种因素影响(酸碱失衡、心肌缺血缺氧、心衰、贫血、药物间影响、肝脏损害,F=4.260,P<0.01),而非老年组仅与心衰有关(F=4.195,P<0.05)。提示老年中毒易受临床背景因素影响是其地高辛耐受量小且变异大的原因;积极改善全身状况,更要结合临床背景的个体化给药,更小的剂量和分次服用,心电监护和慎用有抑制传导的药物是降低老年人中毒率的关键。     

血栓调节蛋白和血管性血友病因子判断肝移植排斥反应的价值

目的 寻找早期诊断和监测肝移植排斥反应敏感和特异的实验室检查项目及指标。 方法 随机观察肝移植患者41例,其中出现排斥反应16例(急性排斥12例,慢性排斥4例)。在术前、术后隔天检测血浆可溶性血栓调节蛋白(STM)和血管性血友病因子(vWF)含量。 结果 有排斥者术后、排斥前2d、急性排斥后STM含量明显升高(分别为5.58 ng/ml ±0.42 ng/ml、5.93 ng/ml±0.45 ng/ml、7.88 ng/ml±0.29 ng/ml)和vWF含量亦明显升高(分别为101.2％±4.68％、104.3％±5.87％、127.7％±5.47％);在排斥反应的前2d,STM(5.93 ng/ml±0.45 ng/ml)和vwF(104.3％±5.87％)含量均明显升高;急性排斥较慢性排斥高(7.88 ng/ml±0.29 ng/ml与6.35 ng/ml±0.54 ng/ml,t=2.46,P<0.05)、冲击治疗无效组较有效组高(8.30 ng/ml±0.1 9 ng/ml与3.82 ng/ml±0.22 ng/ml,t=12.98,P<0.01)、治疗后死亡组较生存组高(7.98 ng/ml±0.18 ng/ml与6.51 ng/ml±0.41 ng/ml,t=3.39,P<0.01)。结论 STM和vWF可作为监测肝移植排斥的实验室项目和指标;STM含量不仅可作为肝移植排斥的早期预报指标,还适用于鉴别急、慢性排斥反应,并可作为冲击治疗疗效和判断预后的指标。     

干扰素α1b联合胸腺肽α1治疗慢性乙型丙型肝炎

对慢性乙型肝炎50例,慢性丙型肝炎20例,应用胸腺肽α1和干扰素α1b。联合治疗6个月,治疗后其PCR-HBV-DNA的阴转率为68.0％(3/50),PCR-HCV-RNA的阴转率为70.0％(14/20),较对照组(干扰素。α1b)的PCR-HBV-DNA的阴转率44.0％(25/50)、PCR-HCV-RNA的阴转率30.0％(6/20)为高,P<0.05。通过治疗前、后检测T细胞亚群、sIL-2R及TNFα发现,治疗前CD_8~ (35.3±6.65％/27.1±4.28％),sIL-2R(820±141.9ng/ml/250±59.64u/ml),和TNFα(6.8±1.14ng/ml/2.55±0.38ng/ml)明显增高,经胸腺肽处理后,CD_8~ (28.3±4.85％)、sIL-2R(378±86.81mg/ml)和TNFα(3.94±0.53ng/ml)均明显下降,相反CD_4~1(38.6±4.90％)相应增高,P<0.01。说明胸腺肽通过调整T细胞活性,促进CD_4~ 成熟提高了干扰素的抗病毒疗效。     

葛根素对牛动脉内皮细胞的作用

本文探讨了葛根素对牛内皮细胞的作用。在细胞培养液中加入葛根素(250μg/ml)为实验组;不加则为对照组。经37℃6h 培养后,分别测定内皮细胞内外液中羟(?)氨酸和糖胺多糖的含量。结果表明,葛根素对牛内皮细胞有明显作用,羟脯氨酸含量由对照组细胞内液和外液中的3.35±0.05μg/ml 和2.68±0.10μg/ml 下降至实验组的2.70±0.06μg/ml(P<0.01)和2.43±0.21μg/ml(P<0.05);糖胺多糖由对照组细胞内液和外液的1.17±0.12μg/ml 和1.57±0.08μg/ml,降至实验组的0.95±0.12μg/ml(P<0.01)和1.68±0.15/μg/ml。     

索他洛尔与地高辛联用控制持续性心房颤动心室率的研究

目的 :评估联合应用索他洛尔与地高辛控制持续性心房颤动 (房颤 )心室率的疗效和安全性。方法 :2 2例持续性房颤患者 ,应用地高辛 0 .2 5mg /d治疗 1周后 ,随机分为两组 ,一组维持原治疗 1周 ,另一组联合应用索他洛尔 80～ 16 0mg/d治疗 1～ 2周 ,观察两组治疗前后静息心室率、运动耐量以及不良反应。结果 :索他洛尔联用地高辛组治疗前及治疗 1周以后静息的心室率分别为 (95 .6± 17.6 )次 /min及 (75 .3± 8.3)次 /min ,降低幅度 2 1.2 %(P <0 .0 5 )。治疗后运动耐量活动时间由治疗前的 (2 .9± 1.2 )min延长到 (4.1± 1.8)min ;负荷功率由 (81.8± 2 3.6 )W增加至 (114.5± 2 9.4 )W ,前后比较差异具有非常显著性意义 (P <0 .0 1) ;同时运动负荷后的心室率亦有所下降 ,由用药前的 (171.1± 2 2 .4 )次 /min降至 (15 4 .0± 2 1.5 )次 /min ,降低幅度 17.1%。未见不良反应。单用地高辛治疗者的静息心室率有所下降 ,但运动后的快速心室率无改变。结论 :索他洛尔与地高辛合用可更有效地控制房颤的心室率 ,提高运动耐量。     

口服氯化钾引起腹痛2例

例1:女性,40岁,因患风湿性心脏病、二尖瓣狭窄、心房纤颤入院。入院时心室率160次/分,立即静注西地兰。第二日心室率降至90次/分,改用地高辛每日0.25mg维持和利尿剂口服,尿量增至每日4000ml。第三日加用氯化钾,口服0.75g后5分钟,出     

心室晚电位与左室功能(65例临床分析)

本文研究心室晚电位与左室功能的关系。对65例患者分别进行了心室晚电位、冠状动脉造影和左室造影检查。结果显示,冠状动脉病变者的心室晚电位阳性组和心室晚电位阴性组其每搏量(SV)分别为60.68±22.95 ml和92.36±25.68 ml(P<0.01);心脏指数分别为3.26±1.10和4.14±1.38(L·min~(-1)/m~2)(P<0.05);射血分数分别为46.12±16.87和59.75±12.98(%)(P<0.01)。这表明心室晚电位阳性者的心功能较心室晚电位阴性者低下。     

腹腔镜微创术治疗结直肠癌患者的临床疗效

目的探讨腹腔镜微创术治疗结直肠癌患者血清肿瘤标志物的改变和临床疗效。方法选取结直肠癌患者96例,按照手术方法不同分为开腹手术组(OS组)和腹腔镜微创术组(LS组)。采用ELISA法检测两组患者在术前及术后1 d、7 d和10 d血清中肿瘤标志物癌胚抗原(CEA)、CA19-9和CA242的含量;比较两组患者的临床疗效和术后并发症的发生率。结果 LS组和OS组患者血清中CEA,CA19-9和CA242的含量在术前、术后1 d、7 d和10 d均高于正常组健康人体内的含量,且在术前、术后1 d、7 d与对照组相比,差异有统计学意义(P<0.05或P<0.01),随着术后时间的延长,LS组患者血清中肿瘤标志物CEA,CA19-9和CA242的含量分别为(11.73±1.17)ng/ml,(40.09±3.35)U/ml和(42.77±5.65)U/ml,术后10 d分别下降至(2.12±0.89)ng/ml,(9.71±1.21)U/ml和(7.43±2.87)U/ml,其下降幅度高于OS组,术后10 d血清肿瘤标志物含量与对照组无统计学差异。LS组患者血清CEA,CA19-9和CA242阳性率分别为58.73%,55.56%和52.38%,术后10 d分别下降至9.53%,4.76%和6.34%,与术前比较差异有显著意义(P<0.01)。LS组的手术时间为(224.9±31.4)min,比OS组要长41 min,两组比较差异有显著意义(P<0.01);但LS组患者在术中出血量为(111.3±34.6)ml,低于OS组的(209.4±41.77)min,且差异有显著意义(P<0.01);在术后排气时间上,LS组要早于OS组,分别为(47.5±11.3)min和(63.9±12.7)min,且差异有统计学意义(P<0.05);但在切除肠管长度和切除淋巴数目上两组差异无统计学意义(P>0.05);LS组和OS组术后总体并发症的发生率分别为3.17%和15.16%,具有显著差异(P<0.01)。结论腹腔镜微创术对机体的创伤小,术中出血量少,机体恢复能力快,术后并发症少,能够快速清除血清中的肿瘤标志物,是一种安全可行、疗效确切的治疗方法。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Variabilité des concentrations plasmatiques de l’angiotensinogène et risque d’hypertension artérielle chez le rat transgénique

Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.     

Morphological and immunocytochemical heterogeneity of cultured pinealocytes from one-week-and two-month-old rats: Planimetric and densitometric investigations

Abstract: In vitro preparations of rat pinealocytes are widely used for biochemical analyses of signal transduction processes. This paper deals with morphological and immunocytochemical features of such preparations. Special attention was paid to the problems of whether pinealocytes represent a heterogeneous cell population and how such heterogeneity may develop during ontogeny. The investigations were performed with cells which were obtained from the pineal organ of one-week-and two-month-old rats, attached to synthetic peptide-coated coverslips or tissue culture chamber slides, and maintained under in vitro conditions overnight. The attached cells were then fixed with paraformaldehyde. These preparations yielded monolayers of spherical cells of different sizes; most cells were isolated, but some of them were aggregated and formed small clusters. On the average, the cells from the one-week-old animals were smaller than the cells from the two-month-old animals. Immunocytochemical demonstration of S-antigen, a pinealocyte-specific marker, showed that the majority of the cells from two-month-old animals were intensely or moderately labelled. Pinealocytes from one-week-old animals were less S-antigen immunoreactive. Only very few cells (less than 1% displayed glial fibrillary acidic protein (GFAP)-immunoreactivity. Planimetric investigations of the cell size and semiquantitative densitometric investigations of the intensity of the S-antigen immunoreaction revealed that (i) pinealocytes kept in vitro form a heterogeneous cell population, and that (ii) this heterogeneity increases during postnatal development from one-week-old to two-month-old animals. Two groups of pinealocytes can be distinguished based on their developmental fate: pinealocytes of one group grow dramatically, but show only a moderate increase in S-antigen immunoreactivity, and pinealocytes of the other group retain their size, but display a distinct increment in S-antigen immunoreacti vitv.     

Effects of pinealectomy and melatonin administration on certain indices of ovarian hyperplasia and/or hypertrophy in rats with both ovaries intact or after unilateral ovariectomy

Abstract: In earlier studies from other laboratories it was shown that melatonin decreased ovarian weight in rats and inhibited compensatory hypertrophy of the remaining ovary after unilateral ovariectomy. This study was designed to examine the influence of melatonin on certain indices of ovarian hyperplasia and/or hypertrophy in adult female rats with both ovaries preserved and with either an intact pineal gland or with the pineal gland removed (pinealectomy, PX) or, finally, in sham-PX animals. Similar studies were conducted on rats after unilateral ovariectomy, referring the examined parameters to the remaining intact ovary. The studies included mitotic activity of granulosa layer cells and corpus luteum cells, ovarian weight, ovarian cross-sectional area, cross-sectional area of the granulosa layer of all the Graafian follicles and the cross-sectional areas of the corpora lutea, visible on the ovarian cross-section. On the basis of results, we conclude that: 1) the effect of PX on the processes of ovarian hyperplasia and hypertrophy may vary; analogously, exogenous melatonin administration may influence ovarian hyperplasia and hypertrophy in different ways; 2) PX and exogenous melatonin may, under certain conditions, exert similar biological effects, even synergistic effects; 3) melatonin inhibits ovarian growth processes, while the effects of PX are variable; 4) the results indicate that in experiments performed on rats, with the use of two control groups, i.e., intact and sham-PX, melatonin effects on these two groups may differ.