冠状病毒感染对心血管系统的损伤及可能机制

冠状病毒(coronavirus,CoVs)感染主要累及肺部,但对心血管系统损伤作用也不容忽视。CoVs感染引起的心脏损伤并非罕见,其发生与病情的严重程度密切相关。本文首先从CoVs引起心血管损伤的证据入手,进一步探讨了CoVs对心肌的直接损伤,以及肾素血管紧张素(RAS)系统激活和细胞因子风暴与炎症反应对心血管损伤的可能作用机制。相关心血管损伤的可能机制包括,(1)病毒直接作用:CoVs在心肌细胞复制,损伤心肌;(2)RAS系统激活:感染CoVs后,心脏血管紧张素转化酶2(angiotensin-converting enzyme 2,ACE2)的表达下调,激活RAS系统,使得血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)收缩血管功能增强,Ang1-7保护心脏效应减弱;(3)诱发细胞因子风暴:循环细胞因子和全身炎症反应引起心脏损伤;(4)其他:包括低氧血症和儿茶酚胺心脏毒性。本文就相关内容作一综述,为后续的详尽机制和治疗策略研究提供思路。     

Assessment of global and regional left ventricular twist and displacement in anterior myocardial infarction using 2-dimensional strain imaging

The recent development of 2-dimensional strain (2D strain) imaging can provide a powerful alternative for assessing left ventricular (LV) torsion. This study was conducted to evaluate the global and regional left ventricular twist by 2D strain in patients with anterior wall myocardial infarction (AMI). A total of 55 AMI patients were divided into two groups according to their ejection fraction (EF) values (group A: LVEF ⩾ 50%; group B: LVEF < 50%), and 35 normal people served as the control group. Using 2-dimensional strain software, global and regional LV rotation and displacement were obtained at two planes. Compared with the control group, patients of group A showed reduced peak LV twist of the anterior and anterior-septal wall (9.26±1.89 vs 10.74±2.67; 9.71±1.71 vs 11.36±2.29, both P < 0.05), but the radial displacement and global twist were maintained (P > 0.05). Differently, regional and global LV twist and radial displacement in patients of group B deceased significantly, especially in the anterior and anterior-septal wall, as compared with patients in the control or group A (both P < 0.05). Moreover, a strong correlation was noted between peak twist and radial displacement; the twist-displacement loop was markedly distorted in patients of group B. This study demonstrated that 2D strain has a potential ability for quantification of left ventricular global and segment twist and radial displacement in patients with coronary artery disease.     

The effects of inflammatory cytokines on steroidogenic acute regulatory protein expression in macrophages

Objective: To investigate the expression of steroidogenic acute regulatory protein (StAR) in macrophages and the effects of inflammatory cytokines on StAR expression. Methods: The macrophages isolated from ApoE knockout mice and C57BL/6J mice and RAW264.7 cells (a cell line from mouse macrophage. ATCC Number: TIB-71^TM) were cultured in DMEM containing 10% fetal bovine serum. RAW264.7 cells were treated with different inflammatory cytokines (TNF-α, IFN-γ and TGF-β1) and 8-Br-cAMP, a cAMP analog. RT-PCR and Western blot analysis were applied to evaluate the effects of inflammatory cytokines on StAR expression. Results: RT-PCR and Western blot analysis demonstrated the expression of StAR in the macrophages isolated from ApoE knockout mice, C57BL/6J mice and RAW264.7 cells. Proinflammatory cytokines TNF-α and IFN-γ significantly decreased StAR mRNA and protein levels in RAW264.7 cells. The inhibition was dose- and time-dependent. In contrast, anti-inflammatory cytokine TGF-β1 increased StAR mRNA and protein levels. At 1:15 molecular ratio, TGF-β1 blocked the down-regulation of StAR expression mediated by TNF-α. cAMP also induced StAR expression in RAW264.7 cells. When the cells were co-treated with 8-Br-cAMP and TNF-α, 8-Br-cAMP failed to induce StAR expression. Conclusion: Our results provide interesting evidence that inflammatory cytokines regulate StAR expression in macrophages. Received 12 August 2006; returned for revision 28 September 2006; returned for final revision 28 May 2007; accepted by M. Katori 22 June 2007     

Cloning and characterization of a novel gene which encodes a protein interacting with the mitosis-associated kinase-like protein NTKL

NTKL is an evolutionarily conserved kinase-like protein. The cell-cycle-dependent centrosomal localization of NTKL suggested that it was involved in centrosome-related cellular function. The mouse NTKL protein is highly homologous with human NTKL. A novel mouse protein was identified as an NTKL-binding protein (NTKL-BP1) by yeast two-hybrid screening, and the full-length cDNA was amplified based on the result of a sequence data analysis cloning strategy. The full-length cDNA sequence of the NTKL-BP1 gene consists of 2,537 bp, which encode 368 amino acids. A database search revealed that homologues of NTKL-BP1 exist in different organisms, including Arabidopsis thaliana, Drosophila melanogaster, Plasmodium falciparum, Geobacter metallireducens, Anopheles gambiae and human. It suggests that NTKL-BP1 is an evolutionarily conserved protein. The expression of NTKL-BP1 was observed in multiple normal mouse tissues. The interaction of the two proteins was confirmed by co-immunoprecipitation. Moreover, immunofluorescent staining indicated that NTKL and NTKL-BP1 were all localized in the cytoplasm.     

基于复杂网络的《新针灸学》与《经络腧穴学》比较分析研究（英文）

提取《新针灸学》《经络腧穴学》中穴位名称、主治病症信息,基于复杂网络建立穴-症网络,分析两者穴位数量、相互关联程度及主治规律变化,借助拓扑学数据解释变化原因,为传统针灸知识体系的结构化、标准化研究提供具体思路和方法。共纳入《新针灸学》386穴、773种症状、形成152163个穴位配伍对,《经络腧穴学》403穴、253种症状、28755个穴位配伍对。两本教材的穴-症网络存在丰富的差异性,其所载的病症结构化程度随医学知识的更新而提升。《新针灸学》模型具有更加典型的小世界效应,或因其以病症为主要分类手段的优势体现。两本教材穴位定位与主治方面发生许多变化,学科发展、时代背景等方面是变化的主要原因。     

血液透析机超滤控制装置临床使用故障特点调研分析

目的:调研血液透析机内部超滤控制装置故障发生情况及特点,分析原因规范其维护保养。方法:对上海市82家血液净化中心(室)的3 664台透析设备超滤故障进行调研,分析故障发生特点,找出超滤故障和超滤偏差发生原因。从执行透析设备自检程序、制定透析设备维护管理制度、掌握超滤控制装置结构部件误差和其他人为因素4个方面制定血液透析机超滤故障解决方案。结果:在82家血液净化中心(室)的3664台透析机中,超滤故障1 692台(次),其中使用年限>5年的"平衡腔+超滤泵"类故障率最高,占比31.21%。血液透析机临床使用管理制度缺失、透析机日常消毒疏忽和专职透析临床工程师配置不足是超滤故障和超滤偏差发生的主要原因。结论:血液净化中心(室)应定期进行透析设备超滤控制装置的维护检查,规范血液透析机使用管理,严格细致的维护保养,配备专职透析临床工程师,保障血液透析机超滤控制装置日常运作的精准性和稳定性,确保透析患者获得最佳透析效果。     

sST2替代NT-proBNP评价心脏术后肾功能不全患者心功能的临床价值

目的探讨心力衰竭标志物可溶性生长刺激表达因子2(sST2)替代N末端B型脑钠肽前体(NTproBNP)评价心脏术后肾功能不全患者心功能变化的临床价值。方法选择2019年1~6月我科心脏外科手术后肾功能不全患者60例作为试验组,其中男34例、女26例,平均年龄49~78(63.3±4.5)岁;另选取心脏术后肾功能正常患者60例作为对照组,其中男37例、女23例,平均年龄53~77(61.7±3.8)岁。比较两组患者围手术期左心室射血分数、心肌肌钙蛋白、肌酸肌酶、sST2及NT-proBNP等心功能指标。结果试验组患者围手术期NTproBNP显著升高,其变化幅度与其它心功能指标变化幅度差异有统计学意义,不能够准确反映术后心功能的变化程度。而sST2变化幅度与其它心功能指标变化幅度相近,基本能够反映心功能的变化程度。结论在心脏术后肾功能不全患者中,采用心力衰竭标志物sST2替代NT-proBNP作为心功能评价指标,可以真实准确地反映心功能变化程度,其优势明显,具有重要的临床价值。     

学龄儿童肥胖与肠道菌群多样性及菌属丰度的关联研究

目的分析学龄肥胖儿童和正常体重儿童肠道菌群多样性差异, 识别肥胖儿童肠道特征菌属, 为后续相关机制研究和学龄儿童肥胖的防治提供依据。方法基于2016年在上海市嘉定区某小学建立的研究队列人群, 将2016-2018年3年均处肥胖状态的儿童共63名纳入肥胖组, 其中男生43名, 女生20名。在3年均为正常体重的儿童中, 根据年龄、性别和所在班级, 将其与肥胖组儿童进行1∶1匹配, 共选择63名纳入对照组。采用问卷收集儿童基本信息、饮食状况、母乳喂养等情况, 收集两组儿童的粪便样本并进行16S rDNA测序。对质量优化后的测序序列按照97%相似性进行可操作分类单元聚类及物种注释。分析肥胖组和对照组儿童肠道菌群多样性及菌属丰度差异。计算肠道菌群的Ace、Chao1、Shannon、Simpson 4种α多样性指数, 并利用主坐标分析, 在非加权Unifrac距离和加权Unifrac距离的基础上表示β多样性。使用相似性分析(ANOSIM)比较两组β多样性的差异。利用STAMP软件挑选出两组儿童共有菌属中的差异细菌, 并利用广义线性模型(GLM)分析肥胖与α多样性以及显著差异菌属的关联。结果肥胖组...