血清IL-35在病毒感染致心肌炎患者中治疗前后的变化研究

目的探讨血清白细胞介素-35(IL-35)在病毒感染致心肌炎患者中治疗前后的变化。方法选取2012年2月-2016年2月医院收治的68例病毒性心肌炎患者为试验组。另选取同期健康体检的健康人群70例为对照组。采集研究对象静脉血检测病毒,检测肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTn I)、IL-17、IL-35和干扰素-γ(IFN-γ)。结果 68例病毒性心肌炎患者中共检出68株病毒,其中RNA病毒41株占60.29%,DNA病毒27株占39.71%。检出前三位的病毒是柯萨奇病毒B、柯萨奇病毒A和疱疹病毒I型。68例病毒性心肌炎治愈15例,显效35例,有效16例,无效2例,总有效率为97.06%(66/68)。试验组血清IL-17、CK-MB、cTn I和IFN-γ水平分别为(512.75±38.29)pg/ml、(33.55±6.31)U/ml、(0.50±0.22)μg/ml和(1368.62±715.28)ng/L均高于对照组(P0.05),血清IL-35为(192.52±29.35)ng/ml低于对照组(P0.05)。试验组患者治疗后血清IL-17、CK-MB、cTn I和IFN-γ水平均降低,血清IL-35水平升高(P均0.05)。不同预后患者治疗前IL-35水平差异有统计学意义(P=0.010)。结论 IL-35在病毒性心肌炎的发生、发展过程中具有重要作用,其基线水平的高低可作为病毒性心肌炎预后判断的重要指标之一。     

乳腺癌MCF-7细胞系9p21缺失断点的精确定位分析

目的 对乳腺癌MCF-7细胞系9p21区缺失断点进行精确定位.方法 采用多重连接探针扩增技术(MLPA)检测MCF-7细胞系9p21区缺失断点的大致区间,采用长PCR扩增缺失断点,引物步移缩小缺失断点的所在区间,测序确定缺失断点的位置.结果 MLPA检测探明MCF-7细胞系的端粒侧断点位于MTAP基因内,着丝粒侧断点位于CDKN2A基因内；通过长PCR、引物步移及测序确定在MCF-7细胞系中,缺失位点位于chr9:21819532至chr9:21989622之间,大小为170kb;断点端粒侧位于MTAP基因的内含子4内,着丝粒侧位于CDKN2A(p14)基因的内含子1内近外显子1β处.结论 长PCR是缺失断点定位的良好方法.在MCF-7细胞系中,存在一个起于MTAP基因内、止于CDKN2A基因内、大小为170kb的缺失片段,其意义有待进一步研究.     

花生四烯酸细胞色素P450表氧化酶在自发性高血压大鼠血压的调节中的作用

背景与目的花生四烯酸细胞色素P450（CYP）表氧化酶代谢花生四烯酸产生表氧化廿烷酸（EETs），又称为内皮源性超极化因子（EDHFs），在局部微循环的调节中起着重要作用。然而EETs在血压的调节中是否起作用还不清楚。本研究通过对成年自发性高血压大鼠导入花生四烯酸细胞色素表氧化酶基因来观察其血压变化，从而进一步明确EETs在血压调节中的作用。方法：将含人类细胞色素P450表氧化酶CYP2J2 cDNA的真核细胞表达质粒pcDNA．2J2经静脉注射（3mg／kg）人雄性成年自发性高血压大鼠，并以pcDNA3．1对照。然后用尾部血压计测量血压。并在注射后3周和4周时处死动物，检测CYP2J2在不同组织中的表达情况。结果：注射质粒后对照组血压一直无显著性变化，而pcDNA．2J2治疗组大鼠血压显著降低（P〈0．05），这一降压效应持续两周以上。Western blotting显示在实验组动物肺、肝和肾的总蛋白中通过特异性抗-CYP2J2抗体可检测出显著量的人类CYP2J2蛋白的表达。结论：本实验显示对成年自发性高血压大鼠导人人类CYP2J2基因，使CYP2J2可以在动物组织中高表达，从而引起相对持久的降压作用，这些结果提示花生四烯酸细胞色素P450表氧化酶通过产生EDHFs参与了动物血压的调节作用。     

中国人血浆同型半胱氨酸水平与微量白蛋白尿的关系

微量白蛋白尿 (MA)是非胰岛素依赖性糖尿病和非糖尿病患者心血管病发病和死亡的强有力的预报因子。高同型半胱氨酸血症 (HHcy)是新近被认为的心脑血管疾病发生的独立危险因素。国外有研究显示 ,HHcy可能与微量白蛋白有一定的联系[1 ] 。本研究通过检测中国人群尿微量白蛋白和血浆同型半胱氨酸 (Hcy)水平 ,并排除其他心血管病相关危险因素的影响 ,探讨中国人血浆Hcy水平与微量白蛋白的关系。一、对象与方法1 .对象 :受试者来源于国家“973”项目 (高血压易患脑卒中及其分子机制的研究 ) ,共 747例 ,男 346例 ,女 40 1例 ,平均年龄 (62 3…     

血浆同型半胱氨酸水平与中国人初发脑卒中预后关系的研究

目的 探讨中国人初发脑卒中患者血浆Hcy水平与其预后的关系.方法 收集291例经CT或MRI诊断的初发脑卒中患者,其中缺血性脑卒中196例和出血性脑卒中95例,通过高效液相色谱荧光检测方法测量其血浆Hcy水平,并对患者进行5年的随访观察.结果 Hcy≥18 μmol/L组缺血性脑卒中患者在5年内终点事件(死亡或心脑血管事件)的发生率显著高于Hcy＜18 μmol/L组(分别为50.9%和28.7%,P＝0.004),相对危险为2.363 (95% CI,1.209 -4.617,P＝0.012).多因素logistic回归分析显示在排除其它危险因素的情况下,血浆Hcy水平升高(≥18 μmol/L)仍与缺血性脑卒中患者5年内发生终点事件显著相关(OR,2.492,95% CI,1.148-5.407,P＝0.021).然而,出血性脑卒中患者血浆Hcy水平升高与其终点事件无明显相关性.结论 血浆Hcy水平升高是缺血性脑卒中患者发生死亡或新发心脑血管疾病的独立危险因素,而与出血性脑卒中患者的预后无明显关系.     

青年与中老年主动脉夹层患者的临床资料对比分析

目的:分析对比青年与中老年主动脉夹层患者的临床资料,了解青年主动脉夹层患者的临床特点。方法:回顾性分析542例主动脉夹层患者的临床资料,根据年龄将其分为青年组(年龄≤44岁)及中老年组(年龄>44岁),其中青年组126例,中老年组416例。结果:2组在起病是否有诱因、入院是否有疼痛方面无明显统计学差异。与中老年组相比,青年组中高血压患者比例低(X2=15.22,P<0.001),吸烟者比例低(X2=10.67,P=0.001),饮酒者比例低(X2=4.58,P=0.038),Marfan综合征者比例高(X2=108.56,P<0.001),既往有糖尿病病史、冠心病病史者2组无明显统计学差异,青年组入院时平均心率较快(P=0.001),甘油三酯(TG)水平较高(P=0.001),入院后血压控制至达标水平(<120/80mmHg)所需的时间较长(P=0.042),青年组行介入及外科手术治疗者的比例较高(X2=27.04,P<0.001),入院时收缩压(SBP)、舒张压(DBP)、胆固醇(TC)、低密度脂蛋白(LDL)、肌酐(Cr)、尿素氮(BUN)、住院期间病死率等方面2组之间均无明显统计学差异。结论:与中老年主动脉夹层患者相比,青年主动脉夹层患者有其自身的临床特点,青年主动脉夹层患者采取介入及外科手术比例较高。     

Throat Infection, Neck and Chest Pain and Cardiac Response： A Persistent Infection-Related Clinical Syndrome

Dizziness, chest discomfort, chest depression and dyspnea are a group of symptoms that are common complaints in clinical practice. Patients with these symptoms are usually informed that while neurosis consequent to coronary heart disease is excluded nonetheless they remain unhealthy with no rational explanation or treatment. 165 cases of these symptoms and 85 control subjects were reviewed and underwent further medical history inquiry, routine EKG test and cardiac ultrasound examination. Thirty-five patients received coronary artery angiography to exclude coronary heart disease. Serum myocardial autoantibodies against beta1-adrenoceptor, alpha-myosin heavy chain, M2-muscarinic receptor and adenine-nucleotide translocator were tested, and inflammatory cytokines and high sensitivity C-reaction protein were measured and lymphocyte subclass was assayed by flow cytometry. All patients had a complex of four symptoms or tetralogy： （1） persistent throat or upper respiratory tract infection, （2） neck pain, （3） chest pain and （4） chest depression or dyspnea, some of them with anxiety. Anti-myocardial autoantibodies （AMCAs） were present in all patients vs. 8% in controls. TNF-α, IL-1 and IL-6 were significantly higher in patients than in controls （P〈0.01）. CD3^＋ and CD4-CD8^＋ lymphocytes were significantly higher and CD56＋ lymphocytes lower in patients than those in controls （P〈0.01）. The ratio of serum pathogen antibodies positive against Coxsackie virus-B, cytomegalovirus, Mycoplasma pneumoniae and Chlamydia pneumoniae were all markedly higher in patients. These data led to identification of a persistent respiratory infection-related clinical syndrome, including persistent throat infection, neck spinal lesion, rib cartilage inflammation, symptoms of cardiac depression and dyspnea with or without anxiety.     

Elevated homocysteine and C-reactive protein levels independently predict worsening prognosis after stroke in Chinese patients

Increased plasma total homocysteine (tHcy) and high sensitivity C-reactive protein (hsCRP) levels are independent risk factors for cardiovascular disease.However, the predictive value of tHcy in combination with hsCRP in patients with stroke is not known.To determine the relationship between tHcy and hsCRP, we enrolled 291 patients with first-onset stroke (196 ischemic and 95 hemorrhagic).Plasma tHcy and hsCRP levels were measured and subsequent vascular events and deaths were determined over a 5-year period.Using the arbitrary cutoff for tHcy (<18 μmol/L and ≥18 μmol/L) and hsCRP (<1 mg/L, 1-3 mg/L and >3 mg/L), the patients were divided into 6 groups.Survival analysis showed that the probability of death or new vascular events during a 5-year follow-up increased according to tHcy and hsCRP levels (P<0.01).The relative risk (RR) of death or new vascular events was 4.67 (95% CI, 1.96 to 11.14, P=0.001) in patients with high tHcy (≥18 μmol/L) and hsCRP (>3 mg/L) compared with those with low tHcy (<18 μmol/L) and hsCRP (<1 mg/L).The increased tHcy level (≥18 μmol/L) combined with increased hsCRP level (>3 mg/L) was still significantly associated with the risk of death or new vascular events (RR, 4.10, 95% CI, 1.61 to 10.45, P=0.003) even when adjusted for other risk factors at inclusion.The combination of increased tHcy and hsCRP levels had a stronger predictive value than increased hsCRP alone or increased tHcy level alone.Further studies are required to evaluate the potential decrease in risks associated with lowering both Hcy and hsCRP levels in patients that present with both increased tHcy and hsCRP.     

中西医结合治疗急性胰腺炎疗效观察

目的:观察探讨中西医结合法治疗急性胰腺炎的临床疗效,总结其临床价值。方法:选取我院2007年11月—2009年11月急性胰腺炎患者52例,随机分为观察组和对照组各26例,观察组采用中西医结合法治疗,对照组单纯使用西医治疗,观察对比两组治疗效果。结果:观察组显效18例,有效7例,无效1例,无并发症发生,总有效率为96.1%;对照组显效17例,有效5例,无效4例,并发症发生6例,总有效率为84.6%;两组治疗效果对比存在明显差异(P<0.05),具有统计学意义。结论:中西医结合治疗急性胰腺炎临床疗效显著,明显优于单纯西医治疗,不良反应小,能有效降低并发症的发生,安全可靠,值得在临床上推广应用。