冠心病患者超敏C-反应蛋白检测分析

目的探讨超敏C-反应蛋白（hs—CRP）与冠心病的关系。方法测定冠心病患者（冠心病组）和健康体检者（对照组）的TC、TG、HDL-C、LDL-C、TC／HDL—C和hs—CRP,对比检测结果。结果与正常对照组比较,冠心病患者血清hs．CRP和TC、TG、LDL—C水平显著增高（P〈0．01,P〈0．05）,而HDL—C水平显著降低（P〉0．01）。结论hs—CRP是已知冠心病患者未来心血管病发病和死亡的预测指标。     

糖尿病和非酒精性脂肪肝的相关性及相关危险因素分析

目的:探讨2型糖尿病和非酒精性脂肪肝的相关性并对相关危险因素进行分析。方法:将门诊及住院新诊断2型糖尿患者分为单纯糖尿病组(T2DM组)和糖尿病合并非酒精性脂肪肝组(T2DM+NAFLD组),检测并比较空腹血糖(FPG)、空腹胰岛素(FNS)、空腹C肽(FC-P),餐后2小时胰岛素(2h NS)、餐后2小时血糖(2 h PG)及餐后2小时C肽(2 h C-P)、糖化血红蛋白(Hb A1c)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、总胆固醇(TC)、三酰甘油(TG)、尿酸(UA)、血压(SBP/DBP)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、超敏C反应蛋白(hs CRP)、同型半胱氨酸(Hcy)及脂蛋白(a)[LP(a))]等各项指标水平,并计算身体质量指数(BMI)、腰臀比(WHR)及稳态模型胰岛素抵抗指数(HOMA-IR)。结果:T2DM+NAFLD组的BMI,HOMA-IR,WHR,SBP/DBP及FPG,FNS及Hb A1c,2 h PG,2 h NS,2h C-P,TC,TG,LDL,ALT,AST,UA,Hcy和LP(a)等各项指标均显著高于T2DM组(P<0.05),而HDL,FC-P,hs CRP却显著低于T2DM组(P<0.05)。结论:糖尿病、肥胖、高胰岛素血症、高脂血症是非酒精性脂肪肝病的高危因素。     

同型半胱氨酸与胰岛素抵抗的相关性及影响因素分析

目的探讨同型半胱氨酸（Hey）与胰岛素抵抗的相关性,分析2型糖尿病高同型半胱氨酸血症（HHcy）的影响因素。方法选择健康体检者30例作为健康对照组,选择2型糖尿病患者130例分为正常体重组、超重组和肥胖组。留取血尿测定Hey及生化指标,计算体重指数（BMI）、稳态模型胰岛素抵抗指数（HOMA—IR）。结果各组血浆Hey水平依次升高。各组间HOM—AIR、BMI、空腹血糖（FPG）、FINS、总胆固醇（HbA1c）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）、尿Alb／Cr、尿素氮（BUN）、收缩压（SBP）、年龄、病程差异有统计学意义（P〈0．05或〈0．01）。性别、肌酐（Cr）、舒张压（DBP）差异无统计学意义（P〈0．05）。相关分析表明Hey与HOMAIR、BMI、FPG、HbA1c、TC、TG、HDL—C、LDL—C、尿Alb／Cr、Cr、SBP、DBP、病程呈显著正相关（P〈0．05）;与性别、年龄、BUN、FINS无相关性（P〉0．05）。进一步多元逐步回归分析显示仅HOMAIR、BMI、SBP、TC、尿Alb／Cr、Cr、FPG与血浆Hey水平独立相关。结论随着胰岛素抵抗的加重,血浆Hey水平逐渐升高。2型糖尿病血浆Hey水平升高与胰岛素抵抗有关。2型糖尿病HOMAIR、BMI、SBP、TC、尿Alb／Cr、Cr、FPG是影响血浆Hey水平的独立相关因素。     

2型糖尿病患者血管内皮生长因子、C反应蛋白与动脉硬化的关系

目的研究2型糖尿病患者血管内皮生长因子（VEGF）和C反应蛋白（CRP）水平变化与动脉硬化的关系。方法酶联免疫分析法和免疫比浊法分别检测2型糖尿病患者（共63例,单纯糖尿病33例,糖尿病动脉硬化者30例）及健康人（31例）血浆VEGF、CRP水平,观察其水平变化与动脉硬化间的关系。结果糖尿病动脉硬化组血浆VEGF、CRP浓度明显高于单纯糖尿病组及正常对照组（P〈0．05）;Logistic回归分析示SBP、TC、TG、HDL、HbA．C、VEGF、CRP与动脉硬化的发生相关。多元相关分析示VEGF与WHR、SBP、FPG、TC、TG、HDL、HbAlc、CRP相关（P〈0．05）;CRP与WHR、SBP、FPG、TC、TG、HDL、HbA1c、VEGF相关（P〈0．05）。结论T2DM动脉硬化患者VEGF、CRP可能参与动脉粥样硬化形成过程。控制血压、血脂、血糖,减轻体质量,抗炎等综合治疗有益于延缓动脉硬化的发生与发展。     

妊娠糖尿病患者血浆 IL－1β水平变化与胰岛素抵抗的关系

目的：探讨妊娠糖尿病患者血浆白介素－1β（IL－1β）水平的变化及与胰岛素抵抗的关系。方法选取妊娠糖尿病组（GDM）65例,正常对照组（NC）55例,同时采集病史、进行体格检查并留取血浆,测定其空腹血糖、胰岛素、血脂和空腹 IL－1β的水平,采用 HOMA－IR 模型公式计算胰岛素抵抗指数,两因素间关系采用 Pearson 相关分析,多个变量间的分析采用多元逐步回归分析。结果 GDM 组 Fins、HOMA－IR 指数较 NC 组增高（ P ＜0．05）,HOMA－β指数较 NC 组降低（ P ＜0．05）,空腹血浆 IL－1β水平 GDM 组显著高于 NC 组（ P ＜0．01）;相关分析 HOMA－IR 指数与IL－1β、SBP、DBP、Fins、FPG、TC、TG、LDL－C 及 apo－B 呈正相关关系（ P ＜0．05）,与 HDL－C 呈负相关关系（ P ＜0．05）。校正 WHR 及 BMI 的影响后,HOMA－IR 指数与 IL－1β、DBP、Fins、FPG、TC、TG 及 LDL－C 呈正相关关系（ P ＜0．05）;与HDL－C 呈负相关关系（ P ＜0．05）。结论妊娠糖尿病患者血浆 IL－1β水平升高可间接反应胰岛素抵抗程度。     

ALT 水平与糖尿病患者糖脂代谢水平的关系研究

目的：探讨2型糖尿病患者（T2MD）血清丙氨酸氨基转移酶（ALT）水平与糖脂代谢水平的关系。方法2012年1月至2014年1月选取本院健康管理中心体检的68例 T2MD患者为研究对象,另选取同期在本院进行葡萄糖耐量试验（OGTT）试验的128例体检者为对照组,根据OGGT试验将体检者分为糖耐量减低组（IGT）60例以及血糖正常组（NGT）组。测定三组血清ALT、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、三酰甘油（TG）、总胆固醇（TC）、低密度蛋白（LCL‐C）、高密度蛋白（HCL‐C）、载脂蛋白B（APOB）、载脂蛋白 A1（APOA1）,并计算各组体质指数（BMI）及胰岛素抵抗指数（HOMA‐IR）。采用Pearson直线相关性分析ALT与IR的关系,Logistic多因素回归分析ALT与HOMA‐IR的关系。结果 T2MD组患者血清ALT、FBG、HbA1c、FINS、TG、TC、LCL‐C、APOB、HOMA‐IR水平显著高于IGT组及NGT组,而IGT组上述各指标高于NGT组,而 HCL‐C、APOA1水平显著低于IGT组及NGT组,差异有统计学意义（P＜0．05）。经Pearson相关分析可知,血清ALT与FINS、FBG、HbA1c、APOB、LCL‐C、HOMA‐IR呈正相关（P＜0．05）,而与APOA1呈负相关（P＜0．05）,与TG、TC、HCL‐C无相关性（P＞0．05）。Logistic多因素回归分析表明,ALT、FBG、HbA1、、LCL‐C是 HOMA‐IR的独立危险因素。结论血清ALT升高与T2MD的发生具有密切的关系,且这种关系可能与血脂血糖及胰岛素分泌功能相关。     

脂肪肝患者丙氨酸转氨酶异常与代谢综合征的相关性研究

目的：探讨脂肪肝患者丙氨酸转氨酶（ALT）异常与代谢综合征（MS）之间的相关性。方法：自2015年1月—12月参加本院健康中心体检人员（n=52092）中,抽取腹部B超提示脂肪肝并接受全套检查者（n=6508）的体检结果,其中ALT指标异常者806例纳入病例组,ALT指标正常者5702例纳入对照组。回顾性分析比较两组体格检查、ALT、FPG、血脂全套、SUA、腹部超声等。结果：病例组的BMI、TC、FPG、SUA、SBP水平均高于对照组（P＜0.05）,而年龄、HDL-C水平低于对照组（P＜0.05）。结论：BMI、FPG、血脂、SBP、SUA水平均是脂肪肝患者ALT异常的危险因素。     

北京市西城区居民高尿酸血症患病率及其与代谢综合征关系的研究

【摘要】目的 了解北京市西城区居民高尿酸血症（HUA）的患病情况及其与代谢综合征（MS）的关系。方法分层随机抽取834名常住居民作为调查对象,对其身高、体质量、收缩压（SBP）、舒张压（DBP）、血尿酸（UA）、空腹血糖（FPG）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）等。根据是否患HUA分为HUA组和非 HUA组。根据MS的4个组分,将调查对象分为：（1）MS0组。不具备MS组分中的任一项。（2）MS1组。具备MS组分中的一项。（3）MS2组。具备MS组分中的两项。（4）MS3组。具备MS组分的三项。（5）MS4组。具备MS组分的四项。分析HUA与MS及其组分的关系。结果调查人群HUA的患病率为12.0%,男性高于女性［21.8%（83/381）vs3.8% （17/453）,χ 2 =63.765,P＜0.01］,且各年龄段男性HUA患病率均高于女性（均P＜0.05）;HUA组BMI、SBP、DBP、TC、TG 均高于非HUA组（均P＜0.01）,2组间HDL-C和FPG差异无统计学意义。HUA组分别合并超重和（或）肥胖、高血压、高血糖、血脂紊乱的患病率均高于非HUA组（均P＜0.01）。HUA患病率随MS组分的增加逐渐升高（χ 2 =46.347, P＜0.01）。结论HUA与MS关系密切,应注重对UA水平的监测。     

健康管理对某部队代谢综合征患者的干预效果观察

目的观察健康管理对部队代谢综合征（MS）患者的干预效果。方法将948例MS患者随机分为干预组和对照组各474例。对照组遵医嘱采用药物治疗和健康指导，干预组在对照组的基础上运用健康管理手段进行综合干预。观察2组干预前后总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL—C）、低密度脂蛋白（LDL．C）等血脂含量及体质量指数（BMI）、空腹血糖（FPG）、尿酸和血压水平变化情况。结果干预后2组患者TC、TG、LDL—C、BMI、FPG、尿酸以及SBP、DBP水平均低于干预前，且干预组低于对照组，差异均有统计学意义（P〈0．01）。结论健康管理可显著改善MS患者代谢相关指标，是防治MS的一种有效管理方法，值得临床推广应用。     

总胆固醇与高密度脂蛋白胆固醇比值预测冠状动脉粥样硬化程度的价值

目的：探讨总胆固醇（TC）与高密度脂蛋白胆固醇（HDL‐C）比值（TC／HDL‐C比值）对冠状动脉粥样硬化程度的预测价值。方法选择因胸闷、胸痛就诊的患者1261例,根据冠状动脉造影结果分为冠心病组（A组,1110例）与无冠心病组（B组,151例）。A组进一步分为单支病变组（A1组,316例）、两支病变组（A2组,303例）和三支病变组（A3组,491例）。计算A组患者Gensini积分。检测血清TC、HDL‐C、低密度脂蛋白胆固醇（LDL‐C）和三酰甘油（TG）浓度,计算 TC／HDL‐C比值。结果 A3组患者的 TC／HDL‐C比值高于A1、A2组（P＜0．05）。A1、A2、A3三组血清 TC、TG、LDL‐C和HDL‐C浓度均无统计学差异。 TC／HDL‐C比值与Gensini积分（r＝0．14,P＜0．01）和冠状动脉病变支数（r＝0．13,P＜0．01）呈正相关。结论 TC／HDL‐C比值可作为评价冠状动脉粥样硬化程度的有效指标之一。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

---

Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.