冠状动脉慢血流现象临床危险因素及形态学研究

目的探寻冠状动脉慢血流现象(CSFP)的临床危险因素,了解冠状动脉形态对心肌梗死溶栓治疗试验(TIMI)血流的影响,推测CSFP的发病机制。方法回顾性收集2017年1月至2019年7月于兰州大学第一医院心脏中心行冠状动脉造影无狭窄病变的患者256例,根据TIMI血流帧数将其中血流减慢的患者设为CSFP组(100例),将血流正常患者设为对照组(156例),按年龄和性别匹配。收集患者临床数据和冠状动脉造影数据,采用二元logistic回归模型分析CSFP的危险因素,并采用Pearson相关分析检验冠状动脉形态学参数与平均校正的TIMI帧数(cTFC)的相关性。结果CSFP组同型半胱氨酸[(22.07±7.27)mmol/L比(18.16±6.63)mmol/L]、中性粒细胞百分比[(44.40±15.60)%比(35.43±12.49)%]、淋巴细胞百分比[3.65%(1.32%,24.65%)比1.80%(1.02%,6.22%)]、平均血小板体积(MPV)[(13.17±1.82)fl比(12.20±1.57)fl]、血小板分布宽度(PDW)[(14.17±2.17)f l比(13.21±2.42)f l]与对照组相比更高,三酰甘油[(3.05±1.37)mmol/L比(3.44±1.36)mmol/L]、纤维蛋白原[(2.65±0.68)g/L比(2.86±0.66)g/L]与对照组相比更低,术中血压更低,冠状动脉平均直径更大,平均远端分支数更少,差异均有统计学意义(均P<0.05)。二元logistic回归模型拟合显示:同型半胱氨酸(OR 1.077,95%CI 1.034~1.123,P<0.001)、中性粒细胞百分比(OR 1.064,95%CI 1.032~1.097,P<0.001)、PDW(OR 1.194,95%CI 1.051~1.356,P=0.006)、MPV(OR 1.338,95%CI 1.127~1.588,P=0.001)是预测CSFP的独立危险因素。相关性分析显示,冠状动脉平均直径与平均cTFC呈显著正相关(r=0.583,P<0.05);冠状动脉平均远端分支数与平均cTFC呈显著负相关(r=-0.508,P<0.05)。结论同型半胱氨酸、中性粒细胞百分比、PDW和MPV是预测CSPF的独立危险因素。冠状动脉平均直径和远端分支数均与冠状动脉平均cTFC密切相关。炎症可能是CSFP发生的关键机制。     

NOD样受体热蛋白结构域3炎性体与心肌缺血再灌注损伤

心肌缺血再灌注损伤(myocardial ischemia-reperfusion injury,MI/RI)是一个多种因素共同参与、相互作用的 炎症级联反应过程。NOD样受体热蛋白结构域3(NOD-like receptor pyrin domain containing 3,NLRP3)炎性体作为固有免 疫系统的重要组成部分在MI/RI的炎症损伤过程中扮演关键角色。此外,阻断或抑制 NLRP3炎性体激活及其下游炎症 因子释放可能成为MI/RI新的治疗靶点。     

咪喹莫特诱发银屑病的机制研究新进展

临床报道咪喹莫特能诱发人银屑病,实验研究发现咪喹莫特能诱导鼠类银屑病样皮肤改变,且发现有不同的作用机制参与此过程。本文对咪喹莫特诱导鼠类银屑病样皮肤变化过程中发现的作用机制进行综述,为探究银屑病复杂的发病机制和治疗提供新思路。     

1.25-二羟维生素D3与皮肤病

1.25-二羟维生素D3是维生素D的活性形式,参与机体钙磷代谢、免疫反应、应激、炎症以及肿瘤的调控等。大量研究表明,1.25-二羟维生素D3能与T淋巴细胞、树突状细胞、巨噬细胞等发生作用,通过抗光老化、抑制自身免疫细胞的增生及细胞因子的合成和分泌在炎症性皮肤病、自身免疫性皮肤病及皮肤肿瘤中发挥作用。1.25-二羟维生素D3和类似物将在皮肤病治疗方面发挥重要的作用。     

Putative role of proteolysis and inflammatory response in the toxicity of nerve and blister chemical warfare agents: implications for multi-threat medical countermeasures

Despite the contrasts in chemistry and toxicity, for blister and nerve chemical warfare agents there may be some analogous proteolytic and inflammatory mediators and pathological pathways that can be pharmacological targets for a single-drug multi-threat medical countermeasure. The dermal-epidermal separation caused by proteases and bullous diseases compared with that observed following exposure to the blister agent sulfur mustard (2,2'-dichlorodiethyl sulfide) has fostered the hypothesis that sulfur mustard vesication involves proteolysis and inflammation. In conjunction with the paramount toxicological event of cholinergic crisis that causes acute toxicity and precipitates neuronal degeneration, both anaphylactoid reactions and pathological proteolytic activity have been reported in nerve-agent-intoxicated animals. Two classes of drugs already have demonstrated multi-threat activity for both nerve and blister agents. Serine protease inhibitors can prolong the survival of animals intoxicated with the nerve agent soman and can also protect against vesication caused by the blister agent sulfur mustard. Poly (ADP-ribose) polymerase (PARP) inhibitors can reduce both soman-induced neuronal degeneration and sulfur-mustard-induced epidermal necrosis. Protease and PARP inhibitors, like many of the other countermeasures for blister and nerve agents, have potent primary or secondary anti-inflammatory pharmacology. Accordingly, we hypothesize that drugs with anti-inflammatory actions against either nerve or blister agent might also display multi-threat efficacy for the inflammatory pathogenesis of both classes of chemical warfare agent.     

七氟烷缺血后处理的心肌保护作用及其机制

已有大量证据表明经典的机械性缺血后处理对心肌缺血/再灌注损伤具有确切的同缺血预处理相似的保护作用,并已在临床上运用。实验研究表明,七氟烷缺血后处理作为抗心肌缺血/再灌注损伤的一种新方法,可减少再灌注心肌的梗死面积、减轻线粒体损害,以及改善再灌注后心脏的血流动力学等,有一定的应用前景。其心肌保护作用涉及复杂的机制,如阻断线粒体通透性转运孔、激活凝脂酰肌醇3-激酶、细胞外信号调节激酶1/2以及线粒体ATP敏感性K通道等。     

NF-κB对非酒精性脂肪性肝病发病过程的影响

随着经济的发展和人们生活水平的提高，非酒精性脂肪性肝病(non-alcoholic fatt y liver disease，NAFLD)在全 球范围内的患病率明显提高。NAFLD本质上是一种慢性炎症性疾病。NF-κB作为一种转录因子，参与机体的炎症反 应、免疫反应、细胞增殖及凋亡过程，可以通过胰岛素抵抗、氧化应激、肠道菌群失调及活化肾素-血管紧张素系统 等机制促进NAFLD的发生与发展。     

脂肪因子在银屑病发病机制中的研究进展

银屑病是一种慢性炎症性皮肤病,患者多伴有系统性代谢性疾病。脂肪组织作为内分泌器官可分泌多种脂肪因子参与多种代谢性疾病和炎症性疾病的发病。目前的研究证实一些脂肪因子可能参与银屑病的发病过程,并且为将来的诊断治疗提供新的生物学标志。     

Patented antiinflammatory plant drug development from traditional medicine

Patents secured on antiinflammatory plant drugs derived from 38 plants are reviewed. An attempt has been made to compare the modern and traditional use of plant drugs and to establish the relevance of folk claims in developing modern drugs. The role of plant botanicals such as polysaccharides, terpenes, curcuminoids, alkaloids, etc. in alleviating inflammatory diseases including arthritis, rheumatism, acne skin allergy and ulcers is highlighted. Chemicals that alleviate swelling are derived from plants including grape, boswellia, turmeric, devil's claw and some essential oils such as clove, eucalyptus, rosemary, lavender, mint, myrrh, millefolia and pine have been patented and used as mixed formulations. Plants containing polysaccharides are the most potent in curing inflammatory diseases.