生长抑素治疗急性胰腺炎40例临床疗效分析

目的探讨生长抑素治疗急性胰腺炎的安全性、有效性。方法将2010年1月～2012年3月入住本院的80例患有急性胰腺炎的患者随机分为治疗组和对照组,各40例。对照组患者采用常规治疗,治疗组患者在常规治疗的基础上加用250μg／h生长抑素。结果治疗组患者加用生长抑素后,患者症状缓解时间、临床治疗时间、血清淀粉酶恢复正常时间均短于对照组（P〈0．05）,且患者并发症发生率、死亡率也小于对照组（P〈0．05）。结论生长抑素治疗急性胰腺炎安全、合理、有效,值得临床深入推广应用。     

Oral administration of myostatin-specific whole recombinant yeast Saccharomyces cerevisiae vaccine increases body weight and muscle composition in mice

Myostatin negatively regulates skeletal muscle growth. It was found that active immunization with myostatin-specific vaccine blocked myostatin function in vivo, which resulted in increase of body weight and muscle composition in mice. However, traditional vaccine and its administration method are expensive and laborious. In this study, we investigated the possibility of using heat-killed whole recombinant yeast Saccharomyces cerevisiae vaccine to modulate myostatin function in mice. The CDS of myostatin was obtained from a pig genome by PCR and subcloned into a yeast expression vector, which was driven by a copper-inducible promoter. Expression of recombinant myostatin was induced by CuSO₄ and confirmed by western blot. We vaccinated mice by oral feeding and subcutaneous injection as comparison. We found that oral feeding resulted in the similar effective immune response than injection, which was measured by the presence of myostatin-specific antibodies in mouse serum. Interestingly, animals vaccinated by both methods demonstrated enhanced growth performance compared to control. All animals were healthy looking throughout the course of experiment, suggesting that whole recombinant yeast vaccine is nontoxic and therefore safe to use. Given the simplicity of its nature, heat-killed myostatin-specific whole recombinant yeast vaccine holds a promise to treat human muscle-wasting diseases in the future.     

Effects of malnutrition with or without eicosapentaenoic acid on proteolytic pathways in diaphragm

Attenuation of muscle wasting has been reported with eicosapentaenoic acid (EPA) use in cachectic states. Pathways mediating muscle proteolysis with severe short-term nutritional deprivation (ND) ± EPA were evaluated, including diaphragm fiber-specific cross-sectional areas, mRNA (real-time PCR) and protein expression (Western blot). Rats were divided into three groups: (1) free-eating controls, (2) ND and (3) ND + EPA. ND significantly influenced multiple proteolytic pathways. EPA significantly reduced mRNA abundances for most genes to control levels with ND. However, discordant muscle protein expression of many genes was noted with the use of EPA, as protein levels failed to fall. EPA had no impact on diaphragm muscle atrophy, despite the impressive mRNA and some protein results. We conclude that EPA does not attenuate diaphragm muscle atrophy with severe levels of ND. Postulated mechanisms include reduction in muscle protein synthesis and persistent ongoing stimuli for proteolysis. Our study provides unique data on proteolytic signals with ND and has important implications for future studies using EPA.     

Sex-specific differences in risk factors for sarcopenia amongst community-dwelling older adults

With considerable variation including potential sex-specific differential rate of skeletal muscle loss, identifying modifiable factors for sarcopenia will be pivotal to guide targeted interventions. This study seeks to identify clinical and biological correlates of sarcopenia in community-dwelling older adults, with emphasis on the role of anabolic and catabolic stimuli, and special reference to gender specificity. In this cross-sectional study involving 200 community-dwelling and functionally independent older adults aged ≥50 years, sarcopenia was defined using the Asian Working Group for Sarcopenia criteria. Comorbidities, cognitive and functional performance, physical activity and nutritional status were routinely assessed. Biochemical parameters included haematological indices, lipid panel, vitamin D level, anabolic hormones [insulin-like growth factor-1 (IGF-1), free testosterone (males only)] and catabolic markers [inflammatory markers (interleukin-6, C-reactive protein) and myostatin]. Multiple logistic regression was performed to identify independent predictors for sarcopenia. Age was associated with sarcopenia in both genders. Malnutrition conferred significantly higher odds for sarcopenia in women (OR = 5.71, 95 % CI 1.13–28.84.44, p = 0.035) while higher but acceptable range serum triglyceride was protective in men (OR = 0.05, 95 % CI 0.00–0.52, p = 0.012). Higher serum myostatin independently associated with higher odds for sarcopenia in men (OR = 1.11, 95 % CI 1.00–1.24, p = 0.041). Serum IGF-1 was significantly lower amongst female sarcopenic subjects, with demonstrable trend for protective effect against sarcopenia in multiple regression models, such that each 1 ng/ml increase in IGF-1 was associated with 1 % decline in odds of sarcopenia in women (p = 0.095). Our findings support differential pathophysiological mechanisms for sarcopenia that, if corroborated, may have clinical utility in guiding sex-specific targeted interventions for community-dwelling older adults.     

Cellular and molecular mechanisms underlying age-related skeletal muscle wasting and weakness

Some of the most serious consequences of ageing are its effects on skeletal muscle. The term 'sarcopenia' describes the slow but progressive loss of muscle mass with advancing age and is characterised by a deterioration of muscle quantity and quality leading to a gradual slowing of movement and a decline in strength. The loss of muscle mass and strength is thought to be attributed to the progressive atrophy and loss of individual muscle fibres associated with the loss of motor units, and a concomitant reduction in muscle 'quality' due to the infiltration of fat and other non-contractile material. These age-related changes in skeletal muscle can be largely attributed to the complex interaction of factors affecting neuromuscular transmission, muscle architecture, fibre composition, excitation-contraction coupling, and metabolism. Given the magnitude of the growing public health problems associated with sarcopenia, there is considerable interest in the development and evaluation of therapeutic strategies to attenuate, prevent, or ultimately reverse age-related muscle wasting and weakness. The aim is to review our current understanding of some of the cellular and molecular mechanisms responsible for age-related changes in skeletal muscle.     

Association between myostatin gene polymorphisms and peak BMD variation in Chinese nuclear families

Summary We identified 17 polymorphisms in myostatin by sequencing, and three informative single nucleotide polymorphisms (SNPs) were selected for further observation for their association with peak BMD of women in 401 Chinese nuclear families. Our results suggest that genetic polymorphisms in myostatin likely play a role in attainment of peak BMD in Chinese women. Introduction Myostatin is a TGF-beta family member that is a negative regulator of skeletal muscle growth. Materials and methods We identified SNPs in myostatin by direct sequencing. Furthermore, using a quantitative transmission disequilibrium test (QTDT). we tested and further test whether SNPs were associated with peak bone mineral density (BMD) variation at the spines and hips of 401 Chinese nuclear families. We identified 17 polymorphisms in myostatin by sequencing. Next, we selected three informative SNPs for further observation of an association with peak BMD of premenopausal women in 401 Chinese nuclear families. Results Using QTDT for the within-family association, we found significant association between rs2293284 and total hip, femoral neck, and trochanter BMD (all p < 0.05), while rs7570532 was associated with total hip and trochanter BMD (p = 0.034 and p = 0.035, respectively). The within-family association was significant between BMI and +2278G > A (p = 0.022). Subsequent permutations were in agreement with these significant within-family association results. Moreover, analyses of the haplotypes confer further evidence for association of rs2293284 and rs7570532 with hip peak BMD variation. Conclusions These results suggest, for the first time, the genetic polymorphisms in myostatin likely play a role in attainment of peak BMD in Chinese women.