原发性高血压患者血清NO、NOS及其亚型水平的分析

目的:测定原发性高血压患者外周血中血清一氧化氮(NO)、一氧化氮合酶(NOS)及其亚型水平,探讨NO/NOS系统参与血压调节的可能机制.方法:原发性高血压患者135例,正常对照组35例.采用化学法检测所有病例外周血的一氧化氮(NO)、总NOS、诱导型一氧化氮合酶(iNOS)和结构型一氧化氮合酶(cNOS)水平并作统计学分析.结果:高血压组NO、NOS、iNOS和cNOS水平均低于正常对照组,且差异具有显著性意义(分别为:P＜0.05,P＜0.01,P＜0.01,P＜0.01);iNOS/cNOS比值与正常对照组相比无显著差异(P＞0.05);对照组和高血压组的NOS浓度与iNOS和cNOS浓度均呈显著正相关;高血压组的cNOS水平与iNOS水平呈显著负相关.结论:高血压患者NO、NOS及其亚型浓度值可以作为临床评估高血压的参考指标;iNOS在正常人体内有表达;在高血压情况下,机体有通过增加iNOS的表达来弥补cNOS水平的病理性降低、调控NOS总体水平从而调节和平衡血压的趋势.     

高血压病血压昼夜节律与心肌缺血的关系

目的 探讨高血压病患者血压昼夜节律改变与心肌缺血之间的关系及临床意义。方法对90例高血压病患者,根据动态心电图上有无心肌缺血(MI)分为MI组(40例)和无MI组(50例),并与20例健康体检者进行对照,观察3组的动态血压变化,同时分析血压昼夜节律正常组和异常组的心肌缺血的发生情况。结果 高血压病伴有MI的患者中,除dSBP、24hDBPL、dSBPL、dDBPL与无MI组比较无统计学差异外,其余各项动态血压指标均明显高于无MI组(P<0.01);高血压病血压昼夜节律异常组发生MI者明显高于血压昼夜节律正常组(P<0.05)。结论 高血压病患者中伴有血压昼夜节律异常者更易导致心肌缺血的发生。对高血压病患者的治疗,除积极控制血压外,还应注意检测和逆转异常的昼夜血压节律,对减少心肌缺血的发生和靶器官损害具有重要意义。     

Detection of radiolabelled bone marrow cells bearing surface ace immunoglobulins by combined autoradiography and immunoperoxidase

A method is described for the simultaneous detection of radiolabelled bone marrow cells bearing surface immunoglobulins by combined autoradiography and immunoperoxidase. Bone marrow cells from normal CBA mice prelabelled in vivo with ¹²⁵IUDR or exposed in vitro to [³H]thymidine were incubated with rabbit anti-mouse immunoglobulins under capping conditions, washed, cytocentrifuged and treated with methanol and hydrogen peroxide to destroy endogenous peroxidase. Cells were then covered with peroxidase-conjugated goat anti-rabbit immunoglobulins, washed, treated with diaminobenzidine a and hydrogen peroxide and finally covered with autoradiographic stripping film and exposed for different times. Peroxidase-positive cells were typically capped and those radiolabelled had autoradiographic silver grains overlying the nucleus.     

Technical improvements in the clotted plasma droplet MIF assay in vitro.

The migration inhibitory activity of culture supernatants of rat and human lymphocytes stimulated with PHA and Con A-Sepharose was tested on cell migration from clotted plasma droplets. This technique was improved by using homologous as well as heterologous plasma and fibrinogen solutions for suspending the migratory cells, automatic micropipettes for performing the technique and purified cell populations as target. The effects of calcium chloride and of the cell concentration in the plasma droplets on the migration indices obtained in the MIF assay were tested.     

Ability of rosetting or non-rosetting individual control and inflammatory macrophages to kill Escherichia coli X43 intracellularly

An autoradiographic method combined with a rosette technique was used to assess the bactericidal activity of individual control and inflammatory peritoneal macrophages (PM phi) in the presence or absence of expression of Fc receptor for IgG (FcR). There was a lack of FcR reactivity in a certain percentage of both categories of PM phi exposed to E. coli X43, a bacterium which is readily phagocytosed in the presence of specific antibody. Both rosetting and non-rosetting PM phi were capable of phagocytosing E. coli X43, but inflammatory PM phi showed a marked reduction in their capacity to ingest these bacteria compared with control PM phi. Once ingested the E. coli X43 were killed equally well by non-rosetting and rosetting control and inflammatory PM phi.     

Chemical Characterization of Macrophage Cytotoxicity Factor,Macrophage Migration Inhibitory Factor,T-Helper Cell-Replacing Factor and Colony-Stimulating Factor from Culture Supernatants of Concanavalin A-Stimulated Murine Spleen Cells

Supernatants from Concanavalin A-stimulated murine spleen cells were subjected to hydrophobic interaction chromatography on phenyl-Sepharose. Macrophage cytotoxicity factor (MCF), macrophage migration inhibitory factor (MIF), T-helper cell-replacing factor (TRF) and colony-stimulating factor (CSF) were bound at high ionic strength and were released stepwise at low ionic strength. CSF thus could be separated from MCF, MIF and TRF and the bulk of other proteins. Chromatography of pools containing MCF, MIF and TRF on Sephadex did not lead to a separation of the three activities which were all found in a molecular weight range of 25.000-55.000. Isoelectric focusing of these pools in pH range from 4 to 9 gave two peaks for MCF at pH 8.2 and 7.2, whereas MIF activity focused from pH 4.5 to 5.5. TRF activity was found in a single sharp peak at pH 5.3. The results demonstrate that the four biological activities can be distinguished on a chemical basis and are accessible for purification and chemical characterization.     

Intravenous Lipid Emulsions in the Prevention and Treatment of Liver Disease in Intestinal Failure

The development of intestinal failure-associated liver disease (IFALD) in pediatric and adult patients on parenteral nutrition is usually multifactorial in nature due to nutritional and non-nutritional causes. The role of lipid therapy as a contributing cause is well-established with the pathophysiological pathways now better understood. The review focuses on risk factors for IFALD development, biological effects of lipids, lipid emulsions and the mechanisms of lipid toxicity observed in laboratory animals followed by a synopsis of clinical studies in pediatric and adult patients. The introduction of fish oil-based lipid emulsions that provide partial or complete lipid replacement therapy has resulted in resolution of IFALD that had been associated with soybean oil-based therapy. Based on case reports and cohort studies in pediatric and adult patients who were at risk or developed overt liver disease, we now have more evidence that an early switch to partial or complete fish oil–based lipid therapy should be implemented in order to successfully halt and reverse IFALD.     

Barriers of Adherence among Palestinian Healthcare Professionals towards the Protocol of Health Education and Counselling on Healthy Behaviours for Non-Communicable Diseases

BackgroundDespite the huge numbers of the universally produced and employed protocols, the adherence with them is still low to moderate in the healthcare settings. This study was employed to assess the attitudes of Palestinian healthcare professionals in Gaza Strip to health education and counseling on healthy behaviours protocol (WHO-PEN Protocol 2), for patients with non-communicable diseases in the Ministry of Health primary healthcare centers.MethodsThis cross-sectional study was conducted with a census sample of all governmental family physicians and nurses (n=175). The study questionnaire was developed based on Cabana theoretical framework. The Arabic version questionnaire was developed based on the cross-cultural adaptation framework. The psychometric properties of the Arabic version questionnaire was finally evaluated.ResultsThe psychometric properties of the Arabic version questionnaire showed good construct validity and internal consistency reliability. The overall adherence level to WHO-PEN Protocol 2 was 70.0, SD=6.9. The main perceived barriers were lack of incentive, patients'' factors, and lack of time. In general, most of healthcare professional respondents had a positive attitude toward the protocol, but this attitude was not predictor to protocol adherence.ConclusionThe good validity and reliability of the questionnaire can provide support for the accuracy of the study results. Varied implementation strategies targeting the major barriers derived from the study are extremely required for addressing the lack of incentives, patients'' factors and time constraints.     

原发性高血压患者骨量减少机制初探

为探讨原发性高血压 (EH)与骨量减少的关系 ,采用双能X线骨密度仪测定了 1 2 1例肝、肾功能正常的EH患者的腰椎 (L2 ～L4 )、股骨上端的骨密度 (BMD) ;采用放免法测定血清骨钙素 (BGP)、甲状旁腺素中间片段 (PTH m) ;采用酶免法测定尿脱氧吡啶啉 (DPD)。结果 :EH病人骨密度均低于正常对照组 ,除女性≤ 4 0岁组外P均 <0 .0 1 ;血清BGP、PTH m、DPD均高于正常对照组 (P <0 .0 1 ) ;且BGP、PTH m、DPD与骨密度呈负相关 ,r分别为 -0 .30 7、-0 .2 68、-0 .2 51 (P <0 .0 1 ) ;而血清钙、磷、碱性磷酸酶与正常对照组无显著差异 (P >0 .0 5) ;男女EH病人骨量减少检出率分别为 4 4.83%及 36.50 % ,骨质疏松检出率分别为 6.90 %及 2 6.98% ,且以股骨上端华氏三角区骨量减少为著。结论 :EH病人存在钙、磷代谢紊乱 ,可导致骨量减少 ,以骨吸收大于骨形成、高骨转换为特点。提示在治疗高血压的同时应补充活性维生素D及钙剂 ,防治骨质疏松的发生。     

心达康对老年高血压病人血清一氧化氮的影响

目的：观察老年高血压一氧化氮（NO）的水平变化及心达康对其的影响。方法：应用比色法测定52例老年高血压病人和30例正常人的血清（NO）水平,其中20例在应用心达康,26例用非洛地平治疗2－4周后,复查血清（NO）水平。结果：老年高血压病人血清（NO）水平较对照组明显降低（P＜0．01）,Ⅱ-Ⅲ级病人明显低于I级病人（P＜0．01）,经心达康治疗后血清NO水平明显升高（P＜0．01）,非洛地平治疗后血清NO无明显变化（P＞0．05）。结论：老年高血压病人体内（NO）水平显降低,且随病情加重而更为显。心达康治疗后（NO）水平明显升高。