湖北省高级知识分子的常见身心亚健康症状调查

目的了解湖北省高级知识分子常见的身心症状,为下一步的防治工作提供依据。方法采用分层整群随机抽样的方法抽取省内部分单位的高级知识分子,共调查了4795名高级知识分子的基本情况、保健情况和常见的身心症状。结果近3个月来,曾有的躯体症状中男性和女性占首位的分别为精力不支(29.04%),腰酸腿疼(31.78%);曾有的心理症状中男性和女性占首位的均为记忆力减退(37.26%,41.01%);广义线性回归模型分析表明,身心症状得分与睡眠状况有关系。结论高级知识分子的健康现状不容乐观,应切实做好高知的预防保健工作。     

Expression and Significance of Toll-like Receptor 2, 4 of Peripheral Blood Mononuclear Cells in Acute Abdomen Patients Associated with Systemic Inflammatory Response Syndrome

The changes of Toll-like receptor (TLR) 2, 4 of peripheral blood mononuclear cells (PBMCs) in the acute abdomen patients associated with systemic inflammatory response syndrome (SIRS) and their potential significance were explored. A clinical study was performed on 103 acute abdomen patients in whom 65 were associated with SIRS. Forty healthy individuals served as normal controls. The mRNA expression of TLR2, 4 was detected by RT-PCR, and the expression of TNF-αand EL-6 by ELISA. The level of plasma endotoxin, hospital stay and mortality were measured. It was found that the endotoxin level was increased to varying degrees in all the acute abdomen patients, and the endotoxin level was and hospital stay longer in SIRS group than in non-SIRS group (P<0.01). TLR2 mRNA, TLR4 mRNA, IL-6 and TNF-αcould be detected with low value in normal controls, but they were up-regulated markedly on the 1st day after admission. Then TLR4 mRNA, IL-6 and TNF-αwere decreased gradually, but TLR2 mRNA maintained at a high level till the 5th day. These indexes above in SIRS group were higher than those in non-SIRS group (P<0.01). The results of correlation analysis revealed the expression of TLR2, 4 mRNA was positively correlated with the levels of TNF-αand IL-6, and the hospital stay. The results of Logistic regression demonstrated that over-expression of TLR2, 4 mRNA might result in higher risk of multiple organ dysfunction syndrome (MODS). It was concluded that in the acute abdomen patients associated with SIRS, the expression of TLR2, 4 in PBMCs was increased markedly, suggesting that TLR might play an important role in the pathogenesis of acute abdomen associated with SIRS.     

50例糖尿病与肺结核并发患者的DR影像分析

目的对糖尿病与肺结核并发时肺部不典型的X线表现进行探讨,提高DR早期诊断率。方法查阅病例及电子影像资料进行回顾性分析。结果影像资料显示:肺部实变阴影10例,斑片、斑点状阴影27例,斑片影伴空洞13例。结论糖尿病与肺结核并发时,X线表现为:肺部病变广泛,呈多叶多段分布;病变以干酪渗出为主,部分呈下肺扩散;空洞以多发空洞为主,注意与各类肺炎、肺化脓及肺部肿瘤等疾病的鉴别。     

诱导型一氧化氮合酶表达与获得性肾囊肿上皮恶变

诱导型一氧化氮合酶在获得性肾囊肿疾病病理诱因的作用下过度表达 ,催化产生过量一氧化氮 ,后者通过多种方式促成囊肿上皮细胞的恶变。对诱导型一氧化氮合酶表达调控及其介导的肿瘤发生、发展过程的研究有助于进一步探索获得性肾囊肿恶变机制。     

内皮素受体阻断剂与肾脏疾病

肾脏疾病发展涉及到许多炎症介质和细胞因子的相互作用 ,近来的研究表明内皮素参与肾脏疾病发生和发展。使用内皮素受体阻断剂能改善肾小球滤过率 ,减轻蛋白尿 ,延缓肾病的进展和肾间质纤维化。     

慢性肾炎患者血浆leptin和血清IL-6、EL-18及SOD检测的临床意义

目的：探讨慢性肾炎患者治疗前后血浆leptin和血清IL-6、IL．18及SOD水平的变化及临床意义。方法：应用放射免疫分析和酶联免疫法对33例慢性肾炎患者进行了血浆leptin和血清IL-6、IL．18及SOD检测,并与35名正常健康人作比较。结果：慢性肾炎患者在治疗前血浆leptin和血清IL-6、IL．18均显着地高于正常人组（P〈0．01）,而血清SOD水平则显着地低于正常人组（P〈0．01）。经中西医结合治疗3个月后与正常人组比较仍有显著性差异（P〈0．05）,血浆leptin水平与血清IL-6、IL．18水平呈正相关（r=0．5718、0．4916,P〈0．01）,而与SOD水平呈负相关（r=-0．6018,P〈0．01）。结论：检测慢性肾炎患者治疗前后血浆leptin和血清IL-6、IL-18及SOD水平的变化对临床观察和预后有重要的临床价值。     

胰岛素泵治疗2型糖尿病的疗效观察

目的观察胰岛素泵治疗2型糖尿病的疗效。方法选取2009年8月—2011年8月于我院就诊的60例2型糖尿病患者,随机分成观察组与对照组,每组各30例。观察组使用胰岛素泵皮下持续进行胰岛素输注,对照组进行常规胰岛素注射治疗。对两组患者治疗前后空腹血糖、餐后2h血糖及晚间10时血糖进行对比。结果同组患者实施治疗前后对比,空腹血糖、餐后2h血糖及晚间10时血糖值有明显降低,同组对比差异有统计学意义(P<0.01);两组患者治疗后空腹血糖、餐后2h血糖及晚间10时血糖对比差异无统计学意义(P>0.05)。结论胰岛素泵连续皮下输注胰岛素治疗2型糖尿病是一种方便、有效、安全的血糖控制方法。     

全身炎症反应综合征小鼠肝脏Toll样受体2,4基因的表达

目的观察Toll样受体(TLR)2,4基因在全身炎症反应综合征(SIRS)小鼠肝脏中的表达,探讨TLR2,4在SIRS发病机制中的作用。方法BABL/C小鼠40只,随机分为对照组和SIRS模型组,每组各20只。按急性重症胰腺炎方法复制SIRS鼠模型。进行血常规和血生化检查(血淀粉酶、谷丙转氨酶等),监测体温。取其胰腺和肝脏观察组织病理学改变。实时荧光PCR法检测肝脏TLR2,4mRNA的表达,Westernblot法检测肝脏TLR2,4蛋白的表达,酶联免疫吸附试验(ELISA)检测肝脏肿瘤坏死因子(TNFα)和白细胞介素(IL)6的表达。结果SIRS鼠胰腺和肝脏组织可见不同程度出血、坏死,伴有炎性细胞浸润。血清淀粉酶和谷丙转氨酶增高,还可见体温和白细胞计数下降。SIRS鼠肝脏TLR2,4mRNA和蛋白表达明显增加,TNFα和IL6的表达亦显著升高,与对照组相比较,差异有显著性(P<0.01)。结论SIRS鼠肝脏TLR2,4基因及其下游炎症因子TNFα和IL6表达明显增加,提示TLR信号通路可能与SIRS的发生发展密切相关,从而为防治SIRS提供了新的思路和必要的理论依据。     

A Rho-kinase inhibitor,fasudil, attenuates progressive glomerulosclerosis induced by daunorubicin in rats

Accumulating evidence suggests that the small G protein Rho and its downstream effec-tor Rho kinase may play important roles in kidney biology. The present study examined the effects of a Rho-kinase inhibitor, fasudil, on daunorubicin-induced progressive glomerulosclerosis and explored the underlying mechanism by which fasudil ameliorates glomerulosclerosis. Thirty-six male SD rats were randomly allocated into sham-operation group （sham group, n=12）, unilateral nephrectomy （UNX）＋daunorubicin （DRB） group （model group, n=12）, UNX＋DRB＋Fasudil group （treatment group, n=12）. Two to four weeks after the establishment of the animal model, 6 rats in each group were taken randomly for the detection of 24-h urine protein excretion. Kidney sections were exam-ined by HE and PAS staining, immunohistochemistry and transmission electric microscopy （TEM）. The expression of Rho-kinase mRNA and P27 mRNA in kidney were detected by RT-PCR. It was found that the 24-h urine protein excretion in model group was increased significantly as compared with sham group （P〈0.01）. But this increase was significantly suppressed by fasudil （P〈0.05）. At 4 week, the foot process effacement in podocytes, mesangial proliferation and ECM accumulation were observed in model group, presenting as focal segmental glomerulosclerosis. But in the treatment group, the fasudil alleviated glomerular injury, with proliferating cell nuclear antigen （PCNA）-positive cell infiltration ameliorated and the expression of P27 increased. The expression of Rho-kinase mRNA was significantly enhanced in model group and was suppressed in treatment group. Moreover, fasudil up-regulated the mRNA expression of P27. Our study demonstrated that the glomerulosclerosis was substantially ameliorated by inhibiting the expression of Rho-kinase. It is suggested that Rho-kinase pathway is involved in the renal injury and the inhibition of Rho-kinase may constitute a therapeutic strategy for the treatment of renal injury.     

缺血预处理对缺血再灌注损伤大鼠肾组织TLR2表达的影响

目的观察缺血预处理对缺血／再灌注损伤大鼠肾组织Toll样受体2（TLR2）表达的影响。方法将24只雄性SD大鼠随机分为3组：假手术对照组（SHAM组）、单纯缺血再灌注组（I／R组）和缺血预处理组（IPC组）,每组8只。于术后24h留取各组大鼠血标本和肾组织。检测各组大鼠血肌酐（SCr）和尿素氮（BUN）,肾组织切片行HE染色后观察其病理学改变,酶联免疫吸附法（ELISA）检测肾组织肿瘤坏死因子-α（TNF-α）含量,实时荧光定量多聚酶链反应检测肾组织TLR2mRNA表达,Westernblot检测肾组织TLR2蛋白表达。结果与SHAM组相比,I／R组大鼠SCr和BUN升高,肾组织TNF-α含量和TLR2蛋白表达升高,差异均有统计学意义（P〈0．01）;与I／R组相比,IPC组大鼠SCr和BUN降低,肾组织TNF-α含量和TLR2蛋白表达降低,差异均有统计学意义（P〈0．05）。结论缺血预处理可能通过抑制大鼠。肾组织TLR2表达及其信号通路,下调TNF-α的表达,发挥其肾脏保护作用。