子痫前期患者脐血和胎盘组织中IGF-Ⅱ检测的临床意义

目的:探讨IGF-Ⅱ在子痫前期发病机制中的作用。方法:用免疫组织化学方法检测正常晚孕组和轻度、重度子痫前期患者胎盘组织中IGF-Ⅱ的表达,同时用ELISA方法检测3组研究对象胎儿脐血中IGF-Ⅱ的含量。结果:IGF-Ⅱ在脐血中的含量,重度子痫前期组显著高于轻度子痫前期组(P<0.001),轻度子痫前期组显著高于正常晚孕组(P<0.01);IGF-Ⅱ在胎盘组织中的表达,重度子痫前期组显著低于轻度子痫前期组(P<0.01),轻度子痫前期组显著低于正常晚孕组(P<0.01)。结论:子痫前期时脐血IGF-Ⅱ含量升高可能是子痫前期病理变化的结果,而胎盘组织中IGF-Ⅱ表达减少可能是引发子痫前期的重要因素之一。     

ACE基因多态性与2型糖尿病肾病的相关性研究

目的 探讨血管紧张素Ⅰ转换酶(ACE)基因的插入／缺失多态性与2型糖尿病(type 2 diabetes mellitus，T2DM)患合并肾病的关系。方法采用聚合酶链反应技术检测109例T2DM患(其中合并肾病患37例，未发生肾病患72例)和260例健康对照组ACE基因插入／缺失多态性。结果糖尿病肾病患的DD基因型频率和D等位基因频率有高于无肾病糖尿病患组的趋势，其频率差异接近显性水准(75．7％vs55．6％，P=0．070；87．8％vs77．1％，P=0．057)。DD基因型糖尿病患合并肾病的频率高于其他基因型，差异有统计学意义(41．2％vs22．0％，P=0．040)。对糖尿病病程与ACE基因多态性的交互作用分析发现，DD基因型与5年以上病程存在交互作用(OR=3．75，95％CI；1．019～13．795)。结论ACE基因的DD基因型可增高T2DM患并发肾病的危险性，并且与糖尿病病程有交互作用。     

不同剂量谷氨酸脱羧酶对非肥胖型糖尿病小鼠发生1型糖尿病的影响

目的不同剂量谷氨酸脱羧酶(GAD)对非肥胖型糖尿病小鼠(NOD)糖尿病免疫干预效果的影响。方法将3周龄40只体重(10.0±0.9)g雌性NOD小鼠分为4组分别腹腔注射GAD0.3mU和不完全弗氏佐剂(IFA)50μL、GAD3mU+IFA50μL、GAD0.03mU+IFA50μL、IFA50μL。8周龄时注射环磷酰胺200mg/kg加速糖尿病,定期检测血糖,眼内眦取血分离血清检测细胞因子白细胞介素(IL)4和干扰素(IFNγ)的变化,动态观察各组糖尿病发生发展的过程。28周时,全部处死,取脾、胸腺作淋巴细胞亚群测定,胰腺作病理组织学观察。结果GAD3mU+IFA50μL组小鼠无一只发生糖尿病,28周时血糖为(5.0+1.1)mmol/L;胰岛个数最多(8.2+2.3)个/张(P<0.01),胰岛炎评分最低(0.33+0.12)(P<0.01);血清中IL4的水平最高为(80+6)ng/L(P<0.01),IFNγ水平最低为(327±48)ng/L;CD8+/CD4+比值最大(P<0.01),在脾脏中为0.524±0.133,胸腺中为0.428±0.021。结论NOD小鼠在3周龄时腹腔注射CAD3mU+IFA50μL混合物比其他剂量组免疫调节效果好,较好地通过调节胸腺,脾淋巴细胞亚群分类,并通过淋巴细胞分泌Th1类因子和Th2类因子来调节Th0细胞的转化,从而抑制NOD小鼠胰岛炎,胰岛β细胞破坏减少,GAD3mU剂量组免疫干预NOD小鼠糖尿病的发生效果最好。     

慢性乙型肝炎病毒感染者血清白细胞介素-2干扰素-γ检测及其临床意义

目的探讨慢性乙型肝炎病毒(HBV)感染者外周血白细胞介素-2(IL-2)、干扰素(IFN)-γ活性与病毒载量、肝功能以及肝纤维化的关系。方法IL-2检测采用放射免疫法(RIA法),IFN-γ检测采用酶联免疫吸附试验(ELISA)。结果HBV-DNA高载量组与低载量组相比IL-2水平明显低下(P<0.05),两组间IFN-γ水平无统计学意义。随着肝功能损害程度加重,IL-2水平逐渐降低,IFN-γ逐渐增高;与非肝硬化组比较,肝硬化组的IL-2的含量显著降低,而IFN-γ显著升高(P均<0.01)。结论在乙型肝炎慢性化过程中,IL-2与HBV清除有关,其降低的程度与肝损伤严重程度及肝纤维化相关;IFN-γ的抗病毒作用不明显,但它作为炎症介质参与了肝脏炎症坏死和肝纤维化的形成过程。     

血管紧张素Ⅱ对乳大鼠心肌细胞时钟基因表达的影响

目的　为研究血管紧张素Ⅱ(AngⅡ)致左心室肥厚是否与时钟机制有关。方法　分离纯化培养的7d龄乳大鼠心肌细胞,分别加入AngⅡ和(或)替米沙坦(Tel)处理,然后提取总RNA ,用RT PCR检测评价心肌细胞时钟基因(Bmal1,mPer2 ,Dbp)的转录水平。结果　与对照组心肌细胞相比,0 .1μmol·L- 1AngⅡ处理72h使心肌细胞时钟基因转录水平显著上调;0 .1μmol·L- 1Tel能拮抗0 .1μmol·L- 1AngⅡ对心肌细胞时钟基因转录上调的作用。结论在正常培养乳大鼠心肌细胞中,时钟基因以日周期节律方式振荡表达,AngⅡ诱导其表达增强,Tel从受体水平拮抗AngⅡ的诱导作用。     

血管紧张肽Ⅱ受体拮抗剂的药动学与临床用药

血管紧张肽Ⅱ受体拮抗剂 (ARB)是一类在血管紧张肽Ⅱ 1型受体 (AT1受体 )水平拮抗血管紧张肽Ⅱ (ATⅡ )的降压药物。它们的药动学各具特色 ,因而具有不同的临床用药特点。氯沙坦 (losar tan)经细胞色素P 450 (CYP) 3A4及 2C9介导转化成其活性代谢物EXP31 74,故在肝功能不全时应减半量使用。替米沙坦 (telmisartan)的T1 / 2 最长 ,谷 /峰比最大 ,与地高辛合用时应动态监测地高辛血浓度 ,以免洋地黄中毒。由于ARB存在降压作用的平台反应 ,单一用药无法控制血压时 ,可联合应用利尿剂或钙拮抗剂。本文就ARB的药动学、降压治疗用药、联合用药 ,肝、肾功能不全时用药及药物相互作用作一综述     

注射用核糖核酸Ⅱ专项评价方法的构建与安全合理性

目的：探讨注射用核糖核酸Ⅱ安全与合理性专项评价研究。方法：本研究按月份分层随机抽取某院2016年9月-2017年8月临床使用核糖核酸Ⅱ的病例270份，药品说明书定量评价、药物利用研究及药品不良反应/事件Logistic回归分析综合评价方法，初步评价核糖核酸Ⅱ的安全合理性。结果：依据药品说明书评价结果提示合理性较高，其中给药剂量（100%），溶媒选择（100%），溶媒剂量（72.59%），给药浓度（74.07%），给药频次（98.15%），给药时间（100%），6项指标12个月内波动幅度与均值保持一致（90.80%）；药物利用研究结果提示，存在超剂量、超浓度给药情况（aDDDs=5.68，aDDCs=7.37，dDUI=1.19，cDUI=1.53）。研究期内发现4例不良反应，均为一般不良反应，经Logistic回归分析提示与药物使用浓度有关。结论：此种评价方法可有效评价药物临床使用的安全合理性，应加强我院核糖核酸Ⅱ临床监测工作，尤其是超剂量、超浓度给药情况。     

Cardiac oxidative stress and dysfunction by fine concentrated ambient particles (CAPs) are mediated by angiotensin-II

Inhalation exposure to fine concentrated ambient particles (CAPs) increases cardiac oxidants by mechanisms involving modulation of the sympathovagal tone on the heart. Angiotensin-II is a potent vasoconstrictor and a sympatho-excitatory peptide involved in the regulation of blood pressure. We hypothesized that increases in angiotensin-II after fine particulate matter (PM) exposure could be involved in the development of cardiac oxidative stress. Adult rats were treated with an angiotensin-converting enzyme (ACE) inhibitor (benazepril^®), or an angiotensin receptor blocker (ARB; valsartan^®) before exposure to fine PM aerosols or filtered air. Exposures were carried out for 5 hours in the chamber of the Harvard fine particle concentrator (fine PM mass concentration: 440 ± 80 μg/m³). At the end of the exposure the animals were tested for in situ chemiluminescence (CL) of the heart, thiobarbituric acid reactive substances (TBARS) and for plasma levels of angiotensin-II. Also, continuous electrocardiogram (ECG) measurements were collected on a subgroup of exposed animals. PM exposure was associated with statistically significant increases in plasma angiotensin concentrations. Pre-treatment with the ACE inhibitor effectively lowered angiotensin concentration, whereas ARB treatment led to increases in angiotensin above the PM-only level. PM exposure also led to significant increases in heart oxidative stress (CL, TBARS), and a shortening of the T-end to T-peak interval on the ECG that were prevented by treatment with both the ACE inhibitor and ARB. These results show that ambient fine particles can increase plasma levels of angiotensin-II and suggest a role of the renin–angiotensin system in the development of particle-related acute cardiac events.     

Bradykinin May Not Be Involved in Improvement of Insulin Resistance by Angiotensin Converting Enzyme Inhibitor

We have previously demonstrated that captopril ameliorates glucose intolerance by partially preventing the reduction in postprandial skeletal muscle blood flow. The present study was designed to clarify the mechanism by which ACE inhibitors affect glucose metabolism in fructose (FRU)-fed Wistar rats with hypertension, glucose intolerance and hyperinsulinermia. Eight-week-old male rats (n=51) were divided into six groups. Controls were given a normal chow, while fructose-rich (55%) chow was administered to the remainder for eight weeks. The different groups were administered alacepril (ALA, 30 mg/kg/day) with or without a continuous infusion of Hoe 140, a kinin B₂ receptor antagonist (150 μ/kg/day), Hoe 140 alone or TCV-116 (1 mg/kg/day), an angiotensin II receptor antagonist, alone. After measuring the body weight and systolic bolld pressure (BP), steady-state plasma glucose (SSPG) levels were determined. FRU significantly increased BP from 141 mmHg in controls to 156 mmHg. ALA with or without Hoe 140 decreased BP to 124 mmHg or 117 mmHg, respectively, but Hoe 140 alone did not affect BP. TCV-116 also decreased BP to 11 6 mmHg. The SSPG levels increased from 7.58 mM in controls to 8.98 mM in FRU-fed rats. This was lowered with both ALA and TCV-116. Hoe 140 alone, however, did not affect SSPG levels. Hoe 140 did not show any effects on ALA-induced improvement of SSPG. These results suggest that the improvement in glucose tolerance observed with ACE inhibitors is not due to the kinins, and angiotensin II receptor antagonists also improve insulin sensitivity.     

Changes in protein and gene expression of angiotensin II receptors (AT1 and AT2) in aorta of diabetic and hypertensive rats

Diabetes and hypertension have been associated with cardiovascular diseases and stroke. Some reports have related the coexistence of hypertension and diabetes with increase in the risk of developing vascular complications. Recently some studies have shown results suggesting that in the early stages of diabetes and hypertension exist a reduced functional response to vasopressor agents like angiotensin II (Ang II), which plays an important role in blood pressure regulation mechanism through the activation of its AT₁ and AT₂ receptors. For that reason, the aim of this work was to study the gene and protein expression of AT₁ and AT₂ receptors in aorta of diabetic SHR and WKY rats. Diabetes was induced by the administration of streptozotocin (60?mg/kg i.p.). After 4 weeks of the onset of diabetes, the protein expression was obtained by western blot and the mRNA expression by RT-PCR. Our results showed that the hypertensive rats have a higher mRNA and protein expression of AT₁ receptors than normotensive rats while the AT₂ expression remained unchanged. On the other hand, the combination of diabetes and hypertension increased the mRNA and protein expression of AT₁ and AT₂ receptors significantly. In conclusion, our results suggest that diabetes with hypertension modifies the mRNA and protein expression of AT₁ and AT₂ receptors. However, the overexpression of AT₂ could be associated with the reduction in the response to Ang II in the early stage of diabetes.