老年性骨质疏松症:一种年龄相关的脂代谢障碍疾病

随着年龄的增加,骨髓中脂细胞逐渐增多,成骨细胞数量及成骨活性下降,破骨活跃,最终导致骨质疏松,但这种病理改变的机制仍不清楚。近来发现可能与以下因素有关:骨髓微环境发生变化;前脂细胞老化导致细胞因子生成增多,影响其脂肪酸代谢方式和对胰岛素的敏感性;过氧化物酶体增殖物活化受体(PPAR)γ等转录因子表达随年龄下降,导致脂细胞分化相关基因表达减少,成脂功能障碍;骨髓间充质干细胞分化方向发生改变,最终造成脂库储脂能力降低及脂质的异位积聚。     

老年人胰岛素抵抗与动脉粥样硬化的关系

目的:探讨胰岛素抵抗(IR)与动脉粥样硬化(AS)的关系。方法:在60岁以上的人群中筛查,体检,记录病史,进行口服75g葡萄糖耐量试验(75 g OGTT)。抽血检查血脂及胰岛素水平,B型超声检查双侧颈总动脉内中膜厚度(IMT)。采用稳态模型(HOMA Model)计算胰岛素抵抗指数(HOMA-IR),根据HOMA-IR值182例研究对象被分为4组,比较各组的危险因素及颈动脉粥样硬化指标。结果:随着HOMA-IR值升高,高血糖(糖耐量低减及糖尿病)、高血压(HPT)、动脉粥样硬化性血管疾病(ASVD)发病率增高(P<0．05～<0．001),甘油三酯 (TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、服糖后2 h血糖(2 h PG)、空腹胰岛素 (FINS)水平增高(P<0．05-<0．001),高密度脂蛋白胆固醇(HDL-C)水平降低(P<0．05),各项AS指标升高 (P<0．01-<0．001)。多元回归分析结果显示,TG、TC、HDL-C、LDL-C、Ln(HOMA-IR)与IMT独立相关 (P<0.05-<0．001),是IMT增高的危险因素。结论:胰岛素抵抗参与动脉粥样硬化的形成。     

动脉粥样硬化不稳定斑块的研究进展

动脉粥样硬化不稳定斑块的破裂是冠心病急性冠脉综合征的主要原因之一。对不稳定斑块的形态特点及病理生理特性的研究,对提高急性冠脉综合征的诊断治疗水平,预防急性冠脉综合征的发生具有重要的临床意义。可通过对动物动脉的物理、化学及生物的损伤建立起不稳定斑块的动物模型,目前对不稳定斑块的研究主要通过建立动物模型。不稳定斑块有其特点:大的脂核、薄的纤维帽、大量炎性细胞浸润及细胞因子如:基质金属蛋白酶、肿瘤坏死因子-α参与等。     

Falha de integridade dos elétrodos de desfibrilhação Riata e Riata ST: um problema atual

Riata and Riata ST silicone defibrillation leads are prone to externalization of conductors due to inside-out abrasion in the high-voltage system, causing structural damage which may be accompanied by electrical failure. These situations are easily detected by fluoroscopy or radiology and by inspection of intracardiac electrograms and/or measurement of impedance. However, older pulse generators do not automatically perform all the measurements needed to assess the integrity of the high-voltage electrical system, nor do they have patient notifier alerts in case of dysfunction.The authors describe the case of a patient in whom structural damage was detected on fluoroscopy during pulse generator replacement. They discuss the best strategy in these patients, considering current knowledge of this dysfunction.     

Non-readioactive nucleiec acid probes: labelling and detection procedures

Abstract: A comprehensive overview is given concerning the in situ hybridizaiton tecnhiques using non-radioactively labelled probes. Details are given on the preparation of the probes with different reporter moelecules and on the corresponding revealing assays. The development of non-isotopic labeeling methods for nucleic acid probes has facilitated the diffusion of the in situ hybridizaiton techniques to the research as well as to the clinical pathology laboratory. Non-radioactive probes have serveral advantages over the radiolabelled ones, including cost, shelf-life, safety and, last but not least. resolutions of the signal.     

Spontaneous kidney rupture due to polyarteritis nodosa presenting as acute abdomen

Received: 24 April 2002 / Accepted: 4 June 2002 Correspondence and offprint requests to: Ertuğrul Kaya?etin, Şehir Cad. Safir Sok. Sültem Blokları, Yıldız Sitesi. No:4/7, Havzan Mah, Meram/Konya, Turkey. Fax: +90 332 3232641; E-mail: ekayacetin@mynet.com     

Idiopathic intracranial hypertension with elevated cerebrospinal fluid level of interleukin-6 in a patient with systemic lupus erythematosus

Received: 26 September 2001 / Accepted: 29 October 2001