The M694V mutation in Armenian‐Americans: a 10‐year retrospective study of MEFV mutation testing for familial Mediterranean fever at UCLA

Familial Mediterranean fever (FMF), inherited in an autosomal recessive manner, is a systemic auto‐inflammatory disorder characterized by recurrent attacks of fever with peritonitis, pleuritis, synovitis and erysipeloid rash. The marenostrin‐encoding fever (MEFV) gene, located on chromosome 16p13.3, is the only gene in which mutations are currently known to cause FMF. To correlate specific genotypes with adverse phenotypes of affected populations residing in the Western United States, a retrospective case series review was conducted of all MEFV gene mutation testing completed at UCLA Clinical Molecular Diagnostic Laboratory between February 2002 and February 2012, followed by clinical chart review of all subjects who either have a single or double mutation. All 12 common mutations in the MEFV gene were analyzed and the M694V variant was found to be associated with an adverse FMF clinical outcome in the Armenian‐American population, manifested by earlier onset of disease, increased severity of disease, and renal amyloidosis.     

1，1－二烷基－4－（3－溴丙酰基）－哌嗪溴化物的合成及生物活性研究

设计合成了七种新的１，１－二烷基－４－（３－溴丙酰基）哌嗪季铵盐溴化物，通过ＩＲ，￣１ＨＮＭＲ和元素分析证实其结构。初步生物活性试验结果表明，Ⅵａ，Ⅵｃ和Ⅵｅ～ｇ有明显的镇痛活性，Ⅵｅ～ｇ还有较好的抗氧化ＳＯＤ活性，但未发现有抗肿瘤作用。     

腺病毒载体携外源基因转染人培养静脉的实验研究

目的 :探讨经腺病毒载体介导的标记基因转染人培养大隐静脉后 ,标记基因表达的效率、转染靶细胞表达时相。方法 :从临床手术患者取得大隐静脉后 ,浸于含AdCMV/LacZ或AdCMV的病毒液中 (5× 10 9pfu) ,孵育 1h ,将静脉剪成静脉片 ,分别培养 2 ,7,14d。对转基因静脉片进行组织学检查。结果 :腺病毒载体可有效地将标记基因 (LacZ基因 )转入培养大隐静脉。转染后 2d内皮细胞和外膜细胞即有表达 ,β 半乳糖苷酶组织化学染色可见胞核蓝染阳性细胞 ,7d时表达最高 ,持续表达到第 14d。对照大隐静脉无β 半乳糖苷酶表达。 结论 :腺病毒载体能高效转染人大隐静脉 ,其靶细胞以内皮细胞为主 ,外源性基因的表达至少维持 2周左右     

脑损伤后高血糖对大鼠血-脑屏障通透性的影响

目的 :研究脑损伤后高血糖对大鼠血 脑屏障通透性的影响。方法 :雄性Wistar大鼠 4 0只 ,随机分为 4组 :正常对照组 (Ⅰ组 ) ,高血糖组 (Ⅱ组 ) ,脑损伤后正常血糖组 (Ⅲ组 ) ,脑损伤后高血糖组 (Ⅳ组 )。应用流体冲击装置制作大鼠脑损伤模型 ,然后分别对高血糖及正常血糖组的血 脑屏障结构的损伤的标记物伊文蓝含量进行测定。结果 :在相同脑损伤的情况下 ,高血糖组的伊文蓝含量明显高于正常血糖组 (P <0 .0 1) ;同时以上 2组的伊文蓝含量均高于正常对照组及高血糖组 (无脑损伤组 ,P <0 .0 0 1) ;而正常对照组与高血糖组的伊文蓝含量无明显差异 (P >0 .0 5 )。结论 :脑损伤后高血糖使大鼠血 脑屏障通透性增高     

SOD在缺血预处理保护大鼠肝脏缺血再灌注损伤中的作用

目的 :探讨超氧化物歧化酶 (superoxidedismutase ,SOD)在缺血预处理保护肝脏缺血再灌注损伤过程中的作用。方法 :应用大鼠部分肝脏缺血再灌注损伤模型 ,检测缺血预处理组 (IP组 )、缺血再灌注组 (I/R组 )及对照组 (C组 )大鼠血清丙氨酸转氨酶 (alaninetransaminase,ALT) ,门冬氨酸转氨酶 (aspartatetransaminase ,AST)及乳酸脱氢酶 (lactatedehydrogenase ,LDH)水平与肝脏病理组织学改变 ,测定其肝脏组织SOD水平的变化并与单纯缺血预处理组 (OIP组 )大鼠进行比较。结果 :IP组的肝脏损害虽较C组重 ,但明显较I/R组轻 ,其 3种血清生化酶均显著低于I/R组 ;OIP组肝组织的SOD水平 (2 14 .95± 2 4 .38)NU/mgprotein均显著高于IP组 (172 .4 3± 15 .2 3)、I/R组 (16 4 .0 3± 30 .0 8)与C组 (16 7.0 3± 2 7.6 0 )NU/mgprotein (P <0 .0 1)。结论 :缺血预处理对大鼠肝脏缺血再灌注损伤具有保护作用 ,其机制与激活肝组织中的SOD有关     

重度妊娠高血压综合征患者脑灌注压变化及其临床意义

目的 :通过检测重度妊娠高血压综合征 (妊高征 )脑灌注压变化 ,探讨脑灌注压变化与头痛症状的关系。方法 :选择重度妊高征 6 9例为实验组 ,正常晚期妊娠妇女 10 0例为对照组 ,采用Aaslid评估脑灌注压方法检测脑灌注压 ,评价妊高征患者脑灌注压变化及与头痛症状的关系。结果 :重度妊高征患者中异常脑灌注压患者明显多于正常脑灌注压患者 (P <0 .0 5 )。严重头痛和轻中度头痛患者脑灌注压均异常 ,且均以脑灌注压增高为多 (P<0 .0 5 )。在脑灌注压增高组中 ,严重头痛组脑灌注压明显高于轻中度头痛组 (P <0 .0 5 ) ;而在脑灌注压减低组中 ,严重头痛组脑灌注压又显著低于轻中度头痛组和无头痛症状组 (P <0 .0 5 )。 3组重度妊高征间平均动脉压比较无显著差异 (P >0 .0 5 )。无头痛症状组有脑灌注压正常和脑灌注压轻度降低 2种状态。结论 :高脑血流灌注状态和低脑血流灌注状态均可导致妊高征脑损害。高脑灌注压和低脑灌注压均是妊高征患者头痛发生的病理生理机制。高脑灌注压是妊高征头痛症状的主要原因 ,高脑灌注压患者更有发生子痫的危险     

A meta-analysis of the effects of dietary protein restriction on the rate of decline in renal function

Dietary protein restriction has been reported to delay the need for renal replacement therapy in clinical trials and meta-analyses. However, less clear is what effect dietary protein has on the rate of decline in renal function. We pooled the results of 13 randomized controlled trials (n = 1,919 patients) and found that dietary protein restriction reduced the rate of decline in estimated glomerular filtration rate by only 0.53 mL/min/yr (95% confidence interval [CI], 0.08 to 0.98 mL/min/yr). We also used weighted regression analysis to determine the reasons for the differences in the results of these 13 randomized trials along with 11 other nonrandomized controlled trials (n = 2,248 patients). The effect of dietary protein restriction (glomerular filtration rate decline in treatment minus control) was substantially less in randomized versus nonrandomized trials (regression coefficient, -5.2 mL/min/yr; 95% CI, -7.8 to -2.5 mL/min/yr; P < 0.05) and relatively greater among diabetic versus nondiabetic patients (5.4 mL/min/yr; 95% CI, 0.3 to 10.5 mL/min/yr; P < 0.05), while there was a trend toward a greater effect with each additional year of follow-up (2.1 mL/min/yr; 95% CI, -0.05 to 4.2 mL/min/yr; P = NS). However, the number of diabetic patients studied was small and the duration of follow-up was short in most trials. No other patient or study characteristics altered the effect of dietary protein restriction on the rate of decline in renal function. Thus, although dietary protein restriction retards the rate of renal function decline, the relatively weak magnitude of this effect suggests that better therapies are needed to slow the rate of renal disease progression.