冠心病患者小而密低密度脂蛋白胆固醇与血浆致动脉硬化指数的相关性

目的 探讨冠心病(CHD)患者小而密低密度脂蛋白胆固醇(sdLDLC)与血浆致动脉硬化指数(AIP)的关系。方法 回顾性收集本院2019年9月—2020年6月因胸痛、胸闷入院,疑似CHD行冠状动脉造影检查的525例患者为研究对象,根据冠状动脉造影结果分为CHD组(n＝422)和非CHD组(n＝103)。同时又按照AIP三分位数分为3组:AIP≤－0.056组(n＝176),－0.056＜AIP＜0.208组(n＝175),AIP≥0.208组(n＝174)。测定各血脂指标并计算AIP。比较CHD组和非CHD组的sdLDLC和AIP水平。分析AIP的影响因素和CHD的危险因素。结果 CHD组sdLDLC、AIP、低密度脂蛋白(LDL)亚型LDL3、LDL4显著高于非CHD组,LDL1、高密度脂蛋白胆固醇显著低于非CHD组(P＜0.05)。随着AIP增加,sdLDLC、LDL4显著升高,LDL1、LDL2显著降低(P＜0.001)。多元线性回归分析显示,sdLDLC、高血压史是AIP的独立影响因素(P＜0.05)。多因素Logistic回归分析显示,sdLDLC、AIP是CHD的独立危险因素(P＜0.05)。结论 CHD患者sdLDLC与AIP呈显著正相关,sdLDLC、AIP是CHD发生的独立危险因素。     

Role of transcribed ultraconserved regions in gastric cancer and therapeutic perspectives

Gastric cancer (GC) is the fourth leading cause of cancer-related death. The occurrence and development of GC is a complex process involving multiple biological mechanisms. Although traditional regulation modulates molecular functions related to the occurrence and development of GC, the comprehensive mechanisms remain unclear. Ultraconserved region (UCR) refers to a genome sequence that is completely conserved in the homologous regions of the human, rat and mouse genomes, with 100% identity, without any insertions or deletions, and often located in fragile sites and tumour-related genes. The transcribed UCR (T-UCR) is transcribed from the UCR and is a new type of long noncoding RNA. Recent studies have found that the expression level of T-UCRs changes during the occurrence and development of GC, revealing a new mechanism underlying GC. Therefore, this article aims to review the relevant research on T-UCRs in GC, as well as the function of T-UCRs and their regulatory role in the occurrence and development of GC, to provide new strategies for GC diagnosis and treatment.     

杭州某高校教师体质指数与心血管病危险因素的关系

[目的]分析杭州某高校教师心血管病危险因素随体质指数(body mass index,BMI)增加的变化情况,为杭州高校教工预防心血管疾病提供理论依据。[方法]将436名教师分为体重未超标组(264人)、超重组(135人)、肥胖组(37人);比较各组血压、血糖、血脂、同型半胱氨酸(homocysteine,Hcy)、脂蛋白(a)[liporotein(a),LP(a)]、胱抑素C(cystatin,Cys-C)、超敏C反应蛋白(high sensitivity C reactive protein,hs CRP)的差异;并统计各体重组教工BMI和Hcy、LP(a)、Cys-C、hs CRP的相关性。[结果]与体重未超标组比较,超重组和肥胖组教工的血压、血糖、血脂、Hcy、LP(a)、hs CRP均升高(P<0.05);与超重组比较,肥胖组教工的血压、血糖、LP(a)升高(P<0.05);超重组和肥胖组教师的BMI和Hcy、LP(a)、hs CRP具有正相关关系(P<0.05)。[结论]超重及肥胖与其他心血管危险因素存在聚集现象,对于高校教师中超重、肥胖者,应注意检查和发现多重心血管病危险因素的并存。     

应用调整的膳食平衡指数法评价中年人群的膳食质量

目的 应用调整的膳食平衡指数(DBI-07)评价中年体检人群的膳食质量,从而对目标人群进行针对性的营养干预.方法 于2013年1月～2013年12月选取合肥某三甲医院体检中心,年龄为45～60周岁的体检者.运用膳食平衡指数(DBI-07)对其膳食质量进行评价.结果 在该体检人群中,谷薯类达到以及超过推荐量的人占到47.4％;水果蔬菜达到以及超过推荐量的人仅仅占到0.9％,豆类和奶类仅占1.6％;动物性食物摄入不足的人占到71.5％;将近一半的人摄入油、盐及酒精过多;97.2％的人的食物种类较为丰富;77.4％的人的饮水情况较好.结论 该体检人群的膳食摄入总体还不均衡,均存在着摄入不足和摄入过量的问题,膳食摄入不足与膳食总体不均衡的情况有待进一步改善.     

农村世居民族老年人高血压与体质指数、腰臀比及皮褶厚度关系调查

目的 了解贵州黔南地区3个世居民族农村老年人高血压患病与体质指数(body mass index,BMI)、腰臀比(waist-to-hip ratio,WHR)及上臂皮褶厚度的关系.方法 采用整群抽样方法选取2县3个乡镇8个村的布依族、水族、毛南族60岁以上老年人作为调查对象,测定身高、体重、腰围(waist circumference,WC)、臀围、上臂皮褶厚度及血压,计算BMI、WHR.结果 3个世居民族老年人高血压患病率为37.57％,男女间差异有统计学意义(x2=5.76,P=0.018),民族间差异无统计学意义(x2=4.58,P=0.101).单因素分析显示老年人有无高血压患者中女性的BMI、WHR、WC、臀围及上臂皮褶厚度各指标间差异有统计学意义,男性除臀围外各指标间差异有统计学意义(均有P＜0.05).多因素回归分析显示WC、性别是3个世居民族老年人高血压的独立相关因素,尤以WC对高血压贡献最大.结论 WC、性别是预测该地世居民族老年人高血压病的理想指标,BMI、WHR及上臂皮褶厚度可作为不同民族老年人高血压病预测指标的补充.     

注意力缺陷多动障碍患儿的骨龄发育水平和体质量的研究

目的探讨注意力缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童的骨龄发育水平与体质指数(body mass index,BMI),为ADHD开展有效的治疗与预防措施提供依据。方法采取自愿原则选自本院保健科心理门诊6~11岁的符合美国精神障碍诊断统计手册(DSM-Ⅳ)诊断标准的初诊ADHD儿童53例为观察组,生长发育门诊中选取正常健康儿童53例为对照组,采用数字化摄影仪拍摄左手腕骨正位X线片,用统一标准测量身高、体重,按CHN法(中国人手腕部骨发育评价标准)骨龄标准评价手腕骨龄片。结果观察组身高年龄与实际年龄的差均值(0.8±1.1)与对照组(-0.1±0.6)的比较差异有统计学意义(P0.001),骨龄与实际年龄差均值与对照组比较差异有高度统计学意义(P0.001),遗传身高与预测终身高的差均值(1.1±1.0)与对照组(1.0±0.4)比较差异无统计学意义(P0.05),BMI观察组(18.1±3.5)与对照组(16.2±2.3)两组均值比较差异有统计学意义(P0.05)。结论 ADHD儿童的骨龄发育水平较早,体质指数偏高,不影响成年身高。     

冠心病心肌缺血患者心功能与血清生化指标的相关性

目的探讨冠心病心肌缺血患者心功能指标左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、A/E峰比值(A/E)、室间隔厚度(IVST)、左心房内径(LAD)与血清生化指标缺血修饰白蛋白(IMA)、同型半胱氨酸(Hcy)、C反应蛋白(CRP)、白细胞介素6(IL-6)的相关性。方法随机选取2017年5月至2019年5月本院收治的冠心病患者105例。依据心肌缺血程度分为心绞痛组50例,心肌梗死组55例;另选取同时期来医院体检的健康者50例作为对照组。采用心脏彩超检测3组心功能指标,全自动生化分析仪测定血清IMA、Hcy水平,酶联免疫吸附试验测定血清CRP、IL-6水平。分析心功能指标与血清生化指标间的关系。结果心绞痛组、心肌梗死组的LVEDD、LVESD、A/E、IVST、LAD明显高于对照组,LVEF低于对照组;心肌梗死组的LVEDD、LVESD、A/E、IVST、LAD明显高于心绞痛组,LVEF低于心绞痛组;心功能各指标两两比较,差异均有统计学意义(P0.05)。心绞痛组、心肌梗死组的IMA、Hcy、CRP、IL-6明显高于对照组;心肌梗死组IMA、Hcy、CRP、IL-6明显高于心绞痛组;血清生化各指标两两比较,差异均有统计学意义(P0.05)。冠心病心肌缺血患者LVEDD、LVESD、A/E、IVST、LAD与IMA、Hcy、CRP、IL-6均呈正相关,LVEF与IMA、Hcy、CRP、IL-6均呈负相关(P0.05)。结论随着血清IMA、Hcy、CRP、IL-6水平增高,LVEDD、LVESD、A/E、IVST、LAD均增加,而LVEF降低,提示冠心病患者发生心肌缺血。     

Ursodeoxycholic acid as a means of preventing atherosclerosis,steatosis and liver fibrosis in patients with nonalcoholic fatty liver disease

BACKGROUNDAtherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality in patients with nonalcoholic fatty liver disease (NAFLD). Weight loss is a key factor for successful NAFLD and CVD therapy. Ursodeoxycholic acid (UDCA), which is one of the first-line therapeutic agents for treatment of NAFLD, is reported to have a beneficial effect on dyslipidemia and ASCVD risk because of antioxidant properties.AIMTo evaluate the effects of 6 mo of UDCA treatment on hepatic function tests, lipid profile, hepatic steatosis and fibrosis, atherogenesis, and ASCVD risk in men and women with NAFLD, as well as to assess the impact of > 5% weight reduction on these parameters.METHODSAn open-label, multicenter, international noncomparative trial was carried out at primary health care settings and included 174 patients with ultrasound-diagnosed NAFLD who received 15 mg/kg/d UDCA for 6 mo and were prescribed lifestyle modification with diet and exercise. The efficacy criteria were liver enzymes, lipid profile, fatty liver index (FLI), noninvasive liver fibrosis tests (nonalcoholic fatty liver disease fibrosis score and liver fibrosis index), carotid intima-media thickness (CIMT), and ASCVD risk score. To test statistical hypotheses, the Wilcoxon test, paired t-test, Fisher’s exact test, and Pearson''s chi-squared test were used. RESULTSThe alanine aminotransferase (ALT) level changed by -14.1 U/L (-31.0; -5.3) from baseline to 3 mo and by -6.5 U/L (-14.0; 0.1) from 3 to 6 mo. The magnitude of ALT, aspartate transaminase, and glutamyltransferase decrease was greater during the first 3 mo of treatment compared to the subsequent 3 mo (P < 0.001, P < 0.01, P < 0.001, respectively). At 6 mo, in the total sample, we observed a statistically significant decrease in body weight and levels of FLI: 84.9 ± 10.4 vs 72.3 ± 17.6, P < 0.001, total cholesterol: 6.03 ± 1.36 vs 5.76 ± 1.21, Р < 0.001, low-density lipoprotein: 3.86 ± 1.01 vs 3.66 ± 0.91, Р < 0.001, and triglyceride: 3.18 (2.00; 4.29) vs 2.04 (1.40; 3.16), Р < 0.001. No effect on nonalcoholic fatty liver disease fibrosis score or liver fibrosis index was found. The CIMT decreased significantly in the total sample (0.985 ± 0.243 vs 0.968 ± 0.237, P = 0.013), whereas the high-density lipoprotein (Р = 0.036) and 10-year ASCVD risk (Р = 0.003) improved significantly only in women. Fifty-four patients (31%) achieved > 5% weight loss. At the end of the study, the FLI decreased significantly in patients with (88.3 ± 10.2 vs 71.4 ± 19.6, P < 0.001) and without > 5% weight loss (83.5 ± 10.3 vs 72.8 ± 16.7, P < 0.001). The changes in ALT, aspartate transaminase, glutamyltransferase, total cholesterol, and low-density lipoprotein levels were similar between the subgroups.CONCLUSIONUDCA normalizes liver enzymes greatly within the first 3 mo of treatment, improves lipid profile and hepatic steatosis independent of weight loss, and has a positive effect on CIMT in the total sample and 10-year ASCVD risk in women after 6 mo of treatment.     

Clinical utility of urinary soluble CD163 in evaluation of lupus nephritis patients

Aim of the workTo assess urinary soluble CD163 (sCD136) in systemic lupus erythematosus (SLE) patients compared to healthy controls. In addition to determine its association with different SLE clinical features, laboratory investigations and pathological indices focusing on those suggest renal disease activity.Patients and methodsThe study included 58 SLE patients and 30 controls. SLE disease activity index (SLEDAI) was assessed and patients subdivided into active lupus nephritis (ALN) (renal SLEDAI ≥ 4) and no-renal activity (NRA) SLE patients (renal SLEDAI = 0). Urinary sCD163 was measured by Enzyme-Linked Immunosorbent Assay (ELISA). Urine values were normalized to urinary creatinine excretion. Renal biopsies were performed in 21 ALN patients.ResultsThey were 54 females and 4 males with a mean age 31.8 ± 9.1 years and disease duration 6.2 ± 4.8 years. They were 31 with ALN and 27 NRA SLE patients. Urinary sCD163 level was significantly higher in SLE patients (1.85 ± 0.3) than controls (0.5 ± 0.36, p < 0.001). In ALN, it was significantly higher (2.91 ± 2.52) compared to NRA SLE patients (0.64 ± 0.38) and controls (p < 0.001 in both). The optimum cut-off value above which normalized urinary sCD136 can predict renal activity was > 0.82 with sensitivity of 90.3%, specificity of 88.89%, p < 0.001. Urinary sCD163 significantly correlated with renal (r = 0.75, p < 0.001) but not with extra-renal SLEDAI. It correlated with activity index of renal biopsy (r = 0.46, p = 0.038).ConclusionUrinary sCD163 is a potential biomarker for LN activity. Its level is associated with clinical features, laboratory investigations and pathological indices that indicate renal disease activity.