自杀未遂与5-羟色胺2A受体基因的关联分析

目的 探讨5-羟色胺（5-HT）2A受体基因A-1438G和T102C两种多态性与自杀未遂之间的关系。方法 以149例自杀未遂者为研究对象。190名正常人为对照,采用聚合酶链反应-限制性片段长度多态性（polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)方法,分析5-HT2A受体基因A-1438G和T102C多态性。结果 PCR-RFLP分析发现,男性自杀未遂与5-HT2A受体基因A-1438G多态性的基因型GG关联。结论 5-HT2A受体基因A-1438G多态性可能与男性的自杀易感性相关。     

超声彩色脉搏波技术在定量评价2型糖尿病患者颈动脉弹性变化中的应用

目的 探讨超声彩色脉搏波(UFPWV)技术在定量评价2型糖尿病患者颈动脉血管管壁弹性变化中的应用价值。方法 回顾性研究。纳入2018年7月-2019年3月蚌埠医学院第一附属医院收治的97例2型糖尿病患者为观察组,其中男47例、女50例,年龄20~74(46.6±9.3)岁;根据颈动脉内中膜厚度(IMT)将观察组分为颈动脉粥样斑块组(A组)、颈动脉内中膜增厚组(B组)和颈动脉内中膜正常组(C组),依据下肢动脉有无斑块将C组分为下肢动脉斑块组(C1组)、下肢动脉无斑块组(C2组)。选取2017年12月-2018年12月在蚌埠医学院第一附属医院体检中心血糖及颈动脉IMT正常的健康体检者64人为对照组,其中男25人、女39人,年龄20~74(44.3±12.0)岁。运用UFPWV采集脉搏波速度 (PWV),计算颈动脉收缩早期PWV(PWV-BS)及收缩晚期PWV(PWV-ES),分析各项参数组间的差异。结果 观察组中,A组颈动脉PWV-BS、PWV-ES分别为(9.51±1.25)m/s、(10.79±1.64)m/s,B组分别为(8.47±0.91)m/s、(9.81±1.05)m/s,C组分别为(7.97±0.77)m/s、(9.07±0.74)m/s,对照组颈动脉PWV-BS、PWV-ES分别为(6.10±1.00)m/s、(7.40±1.20)m/s,A组、B组、C组及对照组间颈动脉PWV-BS、PWV-ES测量值依次降低,差异均有统计学意义(P值均<0.05)。C组中,C1组颈动脉PWV-BS、PWV-ES分别为(7.83±0.85)m/s、(8.82±0.59)m/s,C2组分别为(8.14±0.64)m/s、(9.34±0.79)m/s, C1组PWV-ES显著高于C2组,差异有统计学意义(t=3.402,P＜0.01),而两组间PWV-BS的差异无统计学意义(P>0.05)。结论 UFPWV技术可定量评价2型糖尿病患者颈动脉弹性变化,并可通过PWV-ES的改变评估颈动脉形态学正常的患者动脉粥样硬化的进展程度,对临床诊疗具有一定意义。     

Hormone replacement therapy in postmenopausal women: carotid intima-media thickness and 3-D volumetric plaque quantification.

OBJECTIVE: The relationship between postmenopausal hormone replacement therapy (HRT) and the risk of stroke has been investigated in a number of epidemiological studies. However, data concerning the quantitative effects of HRT on carotid atherosclerosis, as measured by noninvasive ultrasound methods, are sparse. METHODS: In the present case, we examined 55 postmenopausal women (mean age 57.6 +/- 4.2 years) who were treated for 4.7 years with estrogens, either alone (n = 11) or in combination with progestins (n = 44). They were compared to 46 control subjects without HRT who were matched for age, hypertension, and various other vascular risk factors. At the study onset and 1.5 years later, all participants were examined by Doppler ultrasound and B-mode sonography, and plaque visualization, intima-media-thickness (IMT) and volumetric quantification of carotid plaques was performed. RESULTS: The HRT group had a significantly lower incidence of carotid plaques (18%) than the control group (61%). The mean TMT for the HRT subjects was 0.52 mm in the common carotid artery and 0.46 mm in the internal carotid artery, as compared to 0.68 and 0.62 mm, respectively, for the control subjects. No significant changes in IMT were found in either group. 3-D evaluation of carotid plaques showed increased plaque volume in women without HRT compared to women with HRT. CONCLUSION: We have obtained quantitative data using different noninvasive ultrasound techniques which demonstrate that women receiving HRT develop less severe carotid atherosclerosis, an effect which may be mediated by direct hormonal effects on the carotid wall and, in part, by the indirect influence of hormones on lipoproteins. HRT may, indeed, be more effective on existing atherosclerotic plaques.     

Relationship of angiotensin-converting enzyme gene polymorphism to carotid wall thickness in middle-aged men

The insertion/deletion (I/D) polymorphism of the human angiotensin-converting enzyme (ACE) gene is a major determinant of circulating ACE levels. The D allele has been suggested to be a potent risk factor for coronary artery disease; however, the effect of the ACE gene on carotid atherosclerosis remains controversial. We therefore studied the relationship between the ACE gene I/D polymorphism and carotid artery intima-media thickness (IMT). A random sample of 300 men aged 50-59 years living in southern Finland were selected, and 233 agreed to participate (74%). Data were collected in 219 subjects. Quantitative B-mode ultrasonography was used to measure the maximum near and far wall IMT of right and left common, bifurcation, and internal carotid artery. The mean maximum IMT (overall mean) was calculated as the mean of 12 maximum IMTs at 12 standard sites. Patients with an IMT higher than 1.7 mm in at least one of 12 standard sites were assumed to have carotid atherosclerosis. The I/D polymorphism was determined by polymerase chain reaction. Overestimation of the frequency of the DD genotype was eliminated by insertion-specific primer and the inclusion of 5% dimethylsulfoxide. No significant differences were found in carotid wall thickness between the three genotypes; the overall mean IMT were 1.18 +/- 0.30, 1.22 +/- 0.24, and 1.08 +/- 0.40 mm in genotypes of II, ID, and DD, respectively. Similarly, the ACE genotypes and allele frequencies did not differ significantly between the subjects with and those without carotid atherosclerosis. There was no association in the subgroups among only nonsmoking subjects or subjects without chronic medication. The present data indicate that the I/D polymorphism of the ACE gene is not related to carotid IMT and is unlikely to play a major role in carotid atherosclerosis.     

Behaviour of the carotid wall in menopausal women with and without arterial hypertension

OBJECTIVE: A study was conducted on the carotid vascular wall to evaluate its behaviour in postmenopausal women suffering from arterial hypertension compared to normotensive postmenopausal women. METHOD: Intima-media thickness(IMT) of carotid artery was determined by ecoduplex scanner in 182 postmenopausal women (age range 40-60 years) divided in four age classes (40-45, 46-50, 51-55, 55-60 years). Ninety-one women presented normal arterial blood pressure (SBP 136.6+/-11.7 and DBP 82.3+/-8.9 mmHg) and 91 were hypertensive (SBP 172.6+/-11.7 and DBP 97.4+/-6.6 mmHg). RESULTS: The normotensive women presented the following IMT values: 1.19+/-0.21 mm (40-45 years), 1.21+/-0.25 mm (46-50 years), 1.25+/-0.20 mm (51-55 years), 1.25+/-0.20 mm (55-60 years). IMT values in hypertensive women were: 1.75+/-0.25 mm (40-45 years), 1.77+/-0.30 mm (45-50 years), 1.91+/-0.28 mm (51-55 years), 2.02+/-0.33 mm (55-60 years). ANOVA test was performed in both groups of women and did not show any significant difference in the four age classes of normotensive women. On the other hand it revealed a statistical significance between 40-45 and 46-50-year-old hypertensive classes (P<0.001) and between 51-55 and 55-60-year-old hypertensive clases (P<0.02). CONCLUSIONS: There was a correlation between age and IMT in the arterial hypertensives, especially in two older classes, and between the duration of menopause and IMT values. The results indicated that carotid wall thickening was constantly higher in hypertensive women compared with normotensive ones.     

Plasma levels of endothelin and early carotid atherosclerosis in diabetic patients.

An increased thickness of the carotid artery wall is thought to be a sign of early atherosclerosis. Since plasma endothelin concentrations were released from vascular endothelial cells, we have investigated the possible relationship between endothelin 1 (ET-1) and arterial wall thickness. Ninety-eight patients with Type 2 diabetes without evidence of macroangiopathy, hypertension, proteinuria or proliferative retinopathy, and 50 non-diabetic subjects were studied. After an overnight fast, blood was taken for ET-1, glucose, HbA1c, lipids, insulin and C-peptide. Arterial wall thickness was measured as the mean of the maximum intimal-medial thickness (IMT) in 16 carotid segments by B-mode ultrasound. ET-1 levels were significantly elevated in diabetic patients with IMT>1100 microm, 8.3 pmol/l (5.2-12.9) compared with control subjects, 7.6 pmol/l (5.0-11.0), p<0.01 and with diabetic subjects with IMT<500 microm, 7.43 pmol/l (4.8-11.1), p<0.01. The diabetic (IMT>1100 microm) study group had also significantly higher levels of insulin, 102.8 +/- 46.4 pmol/l vs control subjects, 77.5 +/- 32.4 pmol/l, p<0.01. In diabetic subjects, no correlation was found between ET-1 and IMT with glucose, HbA1c, lipids, age or duration of diabetes, respectively. We conclude that ET-1 levels are elevated in Type 2 diabetic patients with increased IMT. Thus providing further support for the role of endothelin in atherosclerosis.     

中青年冠状动脉粥样硬化患者颈动脉硬化的超声特征

目的 探讨中青年冠状动脉粥样硬化（CHD）患者颈动脉超声特征。方法 根据冠状动脉造影结果,将我院170例患者分为CHD组105例和对照组65例,再将CHD组分为单支病变组32例、双支病变组34例和三支病变组39例。所有患者年龄均在60岁以下,全部受检者行颈动脉彩色多普勒超声检查,运用统计软件分析所检测的颈动脉声像图参数。结果 中青年冠状动脉粥样硬化患者颈动脉斑块60%为中低回声斑块。CHD组颈动脉内中膜厚度、IMT增厚率及斑块检出率均高于对照组,三支病变组斑块检出率高于单支病变组,颈动脉IMT情况与     

The relationship between carotid and coronary atherosclerotic damage in dialysis patients

BACKGROUND: Data relating carotid ultrasound (CU) to atherosclerotic damage evaluated by coronary angiography in hemodialysis patients are scarce. METHODS: We carried out a cross-sectional study in 33 uremic subjects (age 55 +/- 12 years, 22 male, 7 diabetic), who have been on dialysis for 41 +/- 48 months (range 2-192). Twenty-two underwent a coronary angiography in order to complete clinical evaluation for inclusion on the kidney transplantation waiting list, and 11 because of coronary artery disease (CAD); Gensini's score was calculated. Intima-media thickness (IMT) and presence of plaques were related to the degree of coronary stenosis and to cardiovascular risk factors. Patients were divided into two groups depending on mean IMT (group 1 IM 0.9 mm, n=15). RESULTS: Group 2 was older (60 +/- 8 vs 50 +/- 12 year, p=0.01), had higher frequency of CAD (53 vs 16%, p=0.02) and had higher prevalence of coronary artery stenosis >or= 75% in the right (60 vs 22%, p=0.02), left anterior descending (46 vs 16%, p=0.06) and left circumflex coronary arteriers (60 vs 11%, p=0.05) than group 1. IMT was not related to the degree of CAD evaluated by Gensini's score. IMT sensibility and specificity in detecting the presence of hemodynamically significant coronary stenosis were 64% and 68%, respectively. Coronary narrowing was correlated with the degree of stenosis of common, internal and external carotid arteries (Spearman's rank correlation coefficient). During two years of follow-up, six major cardiac events were recorded and they were related to Gensini's score. CONCLUSIONS: In uremic patients, ultrasonographic evaluation of carotid arteries is a simple, noninvasive examination that could be a helpful tool in detecting coronary atherosclerotic damage, but IMT does not appear to add more information regarding risk stratification of CAD.     

Association of interleukin‐10 promoter region polymorphisms with risk factors of Atherosclerosis

Atherosclerosis is considered as an inflammatory disease, and carotid artery intima‐media thickness (IMT) and carotid plaque are generally used as intermediated phenotype of atherosclerosis. The aim of this study was to investigate whether carotid IMT and plaque are associated with promoter region polymorphisms of interleukin 10 (IL‐10) gene. We recruited 135 subjects from a rural area of south‐eastern part of South Korea. Three polymorphisms in the promoter region of IL‐10 (?1082 A/G, ?819 T/C and ?592 A/C) were genotyped by pyrosequencing. Carotid IMT was measured at common carotid arteries, and carotid bulbs and cardiovascular risk factors such as cholesterol, blood pressure, uric acid and homocysteine were measured using blood samples. Subjects with the minor allele (C) of ?819 T/C or the minor allele (C) of ?592A/C showed lower values in carotid IMT than those with major allele homozygote of each polymorphism (P = 0.018 and P = 0.031, respectively). Subjects with carotid plaque were significantly older and showed higher values in carotid IMT, uric acid and homocysteine than those without plaque (P < 0.01, respectively). In conclusion, the promoter region polymorphisms of IL‐10 gene associate with carotid IMT and plaque. Further studies with larger samples are needed to provide stronger evidence to justify anti‐atheromatous properties of IL‐10.     

Progression of carotid atherosclerosis and the role of endothelin in diabetic patients.

An increased thickness of the carotid artery wall is thought to be a sign of early atherosclerosis. Since vascular endothelium is the site of formation of several substances, we have investigated the rate of progression of carotid atherosclerosis and the contribution of endothelin (ET-1), lipid peroxides [measured as thiobarbituric acid reacting species (TBARS)] and 6-keto-Prostaglandin-F1A (6-keto-PG-F1A) at baseline and after 30-months. Fifty patients with Type 2 diabetes without evidence of macroangiopathy, hypertension, proteinuria or proliferative retinopathy, and 27 healthy, non-diabetic persons were studied. Arterial wall thickness was measured as the mean of the maximum intimal-medial thickness (IMT) in 16 carotid segments by b-mode ultrasound. The IMT values was significantly increased in diabetic subjects (at baseline: 1110 +/- 310 microm, after 30 months: 1260 +/- 280 microm, p < 0.01), but not in control subjects (1100 +/- 280 microm, 1200 +/- 290 microm, respectively). At baseline time both groups had similar levels of ET-1, TBARS and 6-keto-PG-F1A. In 30-months follow-up, the ET-1 level 8.0 pmol/l (5.8-10.7) was significantly elevated in diabetic subjects, compared with the level at baseline time 7.43 pmol/l (4.8-11.1) p < 0.01. No significant differences were found in the other examined parameters in the studied groups. Although insulin levels remained unchanged in the two studied groups, in 30 months follow-up, the insulin level in the diabetic subjects, 92.4 +/- 35.1 pmol/l was significantly elevated compared with those of control subjects 76.0 +/- 31.0 pmol/l, p < 0.05. In conclusion, endothelis is the main associate of the change of IMT value over 30 months in diabetic patients, in whom the extent of atherosclerosis was significantly greater than in control subjects.     

Hormone therapy is associated with preserved smooth muscle structure and dilation in the arterial vasculature of the leg in older women

Long-term hormone therapy (HT) is associated with reduced intima-medial thickness (IMT), an established risk factor for atherosclerotic disease, in the femoral artery of healthy older women relative to age-matched non-hormone users. However, the influence of continuous, long-term HT on the relation between age, IMT, and smooth muscle dilation has not been investigated in the popliteal artery, an artery prone to stiffening and calcification. In the present study, popliteal artery IMT and smooth muscle dilation (the increase in diameter to sublingual nitroglycerin, NTG) were assessed with Doppler ultrasound in young (Y: n=16; age 23+/-1 [mean+/-S.E.M.]), older non-HT (O non-HT: n=14; age 69+/-1), and older HT (O HT: n=8; age 67+/-1) healthy women. The approximately 0.5 mm increase in resting diameter observed in older non-HT women relative to young women was absent in older HT women, as was the age-related increase in IMT (Y: 0.52+/-0.02 mm; O non-HT: 0.63+/-0.02 mm; O HT: 0.56+/-0.02 mm; p<0.05 for age and hormone comparisons). NTG dilation (percent change above rest) was similarly attenuated in older non-HT women (Y: 8.6+/-1%; O non-HT: 3.0+/-0.7%; O HT: 7.4+/-1.7%; p<0.05 for age and hormone comparisons), and NTG dilation was inversely related to IMT (p<0.01). Collectively, these results suggest that long-term, continuous HT may alleviate the detrimental effects of aging on both structural changes and smooth muscle dilation of the popliteal artery in healthy women.     

Serotonin 5-HT(2A) receptor gene polymorphism, 5-HT(2A) receptor function and personality traits in healthy subjects: a negative study

BACKGROUND: Central serotonin-2A (5-HT(2A)) receptor dysfunction is regarded as an important factor in the etiology of affective disorders. The relations between some personality traits and the vulnerability of affective disorders are also implicated. Moreover, there are several reports which describe the association between 5-HT(2A) receptor gene polymorphisms and mental disorders. We therefore examined the relationship between personality traits, the 5-HT(2A) receptor function, and 5-HT(2A) receptor gene polymorphisms. METHODS: 5-HT-induced intraplatelet calcium (Ca) mobilization, 5-HT(2A) receptor gene polymorphisms (A-1438G, T102C, T516C, C1340T, C1354T), and Temperament and Character Inventory (TCI) scores were examined in 133 healthy subjects. RESULTS: Neither 5-HT-induced Ca mobilization nor 5-HT(2A) receptor gene polymorphisms (A-1438G, T102C) appear to be associated with seven personality dimensions including Harm Avoidance. There was no significant difference in the Ca response among the subjects with -1438A/A, A/G and G/G genotypes. Since the appearance of the other types of the 5-HT(2A) receptor gene polymorphisms (T516C, C1340T and C1354T) was quite rare in our sample, we were unable to examine the relationship between these polymorphisms, and the TCI score or the Ca response. LIMITATIONS: Our failure to find a significant association may reflect the false negative results due to the small sample size and low statistical power. Further studies in depressed patients may clarify the complicated relationship between personality traits and the vulnerability of affective disorders. CONCLUSIONS: Personality traits detected by TCI may not be directly related to the 5-HT(2A) receptor function or 5-HT(2A) receptor gene polymorphism which may be involved in the vulnerability of affective disorders.     

Carotid atherosclerosis and the risk factors in early postmenopausal Chinese women

Objectives

To describe the distribution of intima-media thickness (IMT) and the prevalence of plaque by carotid segments, walls and sides, and to examine their associated risk factors in asymptomatic, early postmenopausal Chinese women in Hong Kong.

Methods

Between 2002 and 2004, the study recruited 518 postmenopausal women aged 50–64 years. They were examined by B-mode ultrasound to measure the IMT and the prevalence of plaque at the near and far walls of common carotid (CCA), bifurcation (bulb), and internal carotid (ICA) of both the left and right carotid arteries. Blood pressures, obesity indices, lipids and glucose levels, sociodemographic, medical and lifestyle factors were also obtained.

Results

The mean IMT was 0.76 ± 0.12 mm (range: 0.53–1.33 mm). IMT was significantly thicker on the far wall than on the near wall and differed among segments (being thickest at the bulb and the narrowest at the ICA). 21.8% had at least one plaque in the carotid artery with most of the plaque found at the bulb area. Systolic blood pressure had statistically significant relationship with IMT that were fairly homogeneous among different segments. Lipids were associated with the CCA and bulb IMT, but not the ICA IMT. Diabetes predicted only CCA IMT. Older age, higher waist–hip-ratio and low-density lipoprotein cholesterol were significant predictors of plaques at all sites combined.

Conclusions

We described the distribution of IMT and the prevalence of plaque in asymptomatic, early postmenopausal Chinese women. Associations of risk factors with IMT of different arterial segments were also observed.     

Association between schizophrenia and DRD3 or HTR2 receptor gene variants

Schizophrenia is a severe and common psychiatric disorder afflicting 1% of the world population. A role of many neurotransmitter receptors in schizophrenia was suggested by an association with several polymorphisms located in their coding regions. In this study we examined the contribution of the T-102C and A-206G transitions in the 5-HTR2a and DRD3 receptor genes respectively to genetic susceptibility and phenotypic expression of schizophrenia disorder within the Greek population. We determined by PCR and RFLP analysis the genotype for the above polymorphisms in 114 schizophrenic hospitalized individuals and 192 control samples. In contrast to previous reports from large European multicentre studies, which indicate significant correlation between schizophrenia and C-102 allele of the T-102C polymorphism, in this study we observed a statistically significant overall association between the disorder and allele T-102 (P<0.0001, odds ratio (OR)=2.11, 95% CI=1.48-3.02). We also found a highly significant excess of the T-102/C-102 and C-102/C-102 genotypes in the normal group (P<0.001). Comparison of the patients with the controls for the DRD3 polymorphism (A-206G transition) showed marginally nonsignificant differences in the genotypic (P=0.054) and no significance in the allelic (P=0.163) frequencies. However, the A-206/A-206 genotype seems to positively contribute to the disorder appearance, when compared to A-206/G-206 as genotype base line risk (P=0.016, OR=1.88, 95% CI=1.09-3.26). In conclusion, from genetic association analysis of this schizophrenic population, a significant association is clearly determined between the HTR2 genetic polymorphism and the presence of schizophrenic disorder, manifested as increased risk of schizophrenia for carriers of the T-102 allele.     

Prevalence of asymptomatic carotid stenosis in Korea based on health screening population

We attempted to investigate the prevalence and risk factors of carotid artery stenosis in Korea. Twenty thousand seven hundred twelve individuals who underwent carotid artery ultrasonography for health screening between March 2005 and March 2010 were retrospectively evaluated. The population was divided into four groups, according to the degree of stenosis, as Group A, below 29%; Group B, 30% to 49%; Group C, 50% to 74%; Group D, above 75%. The medical records of the individuals were investigated, and Fisher's exact test, chi-square tests, Kruskal-Wallis tests and a binary logistic regression model were used for statistical analysis. The prevalence of carotid stenosis was Group B, 5.5%; Group C, 0.9%; Group D, 0.1%. Old age, male gender, hypertension, diabetes mellitus and ischemic heart disease were significantly higher in Groups C and D (P = 0.001, 0.001, 0.001, 0.048, and 0.001, respectively). Among the males aged over 65 yr, the prevalence of carotid stenosis ≥ 50% and ≥ 30% were 4.0% and 18.2%, respectively. Asymptomatic carotid stenosis is not uncommon in Korea. Carotid ultrasonography is necessary for people with above-listed risk factors.     

H型高血压合并腔隙性脑梗死患者Hcy水平与动脉粥样硬化的关系

目的 观察H型高血压合并腔隙性脑梗死(lacunar infarction,LI,简称腔梗)患者血浆同型半胱氨酸(hyperhomocysteine,Hcy)的水平与颈动脉粥样硬化的关系.方法 对入选的高血压合并腔梗患者,依据Hcy水平分为H型高血压合并腔梗组(Hcy≥10μmol/L,H型高血压组,n=120);普通高血压合并腔梗组(Hcy＜ 10μmol/L,普通高血压组,n =120);选择同期健康体检人群为对照组(n=115).用酶联免疫吸附试验法(enzyme-linked immunosorbent assay,ELISA法)检测各组受试者Hcy的水平,同时检测一般生化指标.采用彩色多普勒超声测定各组受试者颈动脉IMT.结果 H型高血压组的颈动脉IMT水平明显高于普通高血压组及对照组[IMT:H型高血压组(1.37±0.20)比普通高血压组(1.15±0.18)比对照组(0.57 ±0.22) mm,P＜0.001;Hcy:H型高血压组(19.2±3.5)比普通高血压组(9.2±1.4)比对照组(9.0±1.3).μmol/L,P＜0.001];Pearson线性分析结果显示高血压合并腔梗患者的Hcy水平与IMT呈正相关(r=0.413,P＜0.05),H型高血压组相关性更大(r=0.585,P＜0.05).以IMT为因变量进行多元逐步线性回归分析显示,Hcy(β=0.535,P＜0.01)是颈动脉IMT的影响因素.结论 高血压合并腔梗患者血浆Hcy水平升高与颈动脉IMT增厚呈正相关.H型高血压合并腔梗患者颈动脉粥样硬化更显著.     

Systemic hypertension after kidney transplantation: associated risk factors and influence on graft survival

Systemic hypertension after kidney transplant (HAPT) has been associated with a reduction in graft survival and increased morbidity and mortality of kidney transplant recipients. With the use of calcinuerin inhibitors, prevalence of HAPT has increased to 60-80%. The purpose of this study was to document the prevalence of HAPT in kidney transplant recipients attending the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" associated risk factors and the effect of hypertension in long term graft survival. We retrospectively reviewed the clinical charts of all the patients that underwent kidney transplant from 1984 to 1994. The following risk factors were studied: age, gender, cause of renal failure, presence of hypertension before kidney transplant, histocompatibility, acute rejection episodes, chronic rejection, serum creatinine values and use of cyclosporine. We divided subjects in two groups: normotensive (NT) and hypertensive (HT). HAPT included 3140/90 mmHg blood pressure level observed at least during two consecutive evaluations or the use of antihypertensive medication. We analyzed 215 grafts from 205 patients (10 patients had two kidney transplants); mean age at transplant of 30 +/- 9 years, 131 subjects were female and 84 male. One hundred and eighty eight patients (88%) displayed pretransplant hypertension. The mean follow up was 56+/-32 months. In the postransplant period 152 (71%) were HT and 63 (29%) NT. The HT group had significantly higher blood pressure and serum creatinine values than the NT group (P < 0.001), in spite of an adequate blood pressure control in 65% of the patients from the HT group. The NT group displayed a higher graft survival than the HT group; 60 +/- 30 months vs. 51 +/- 32 months respectively (p<0.01). Multivariate analysis did not show any risk factors independently associated with the development of HAPT. The prevalence of HAPT in our series is similar to the one reported in the literature. During the postransplant period there was a reduction of hypertensive patients (88% pretransplant vs. 71% postransplant). HAPT is a significant risk factor associated with long term survival of the graft.     

原发性高血压患者颈动脉斑块及动脉僵硬度与血清尿酸水平的关系*

 目的：研究原发性高血压（essential hypertension,EH）患者颈动脉斑块性质及动脉僵硬度与血清尿酸（uric acid,UA）水平的关系。方法：选择EH患者92例,健康对照组30例;对所有研究对象行相关血液生化检查,检测颈总动脉内中膜厚度（IMT）、颈动脉斑块和颈股动脉脉搏波传导速度（CFPWV）。结果：EH组的血清UA明显高于对照组［（361.51±83.81)μmol/L vs (317.03±62.22) μmol/L,P<0.05］;EH组IMT及异常检出率较对照组明显升高［(0.69±0.14) mm vs (0.60±0.12) mm,42.39% vs 10.00%,P<0.05］;45例EH患者检出颈动脉斑块,随着颈动脉斑块严重程度增高,血清UA水平依次增高［（285.25±78.41) μmol/L、(341.19±63.99) μmol/L和(401.33±88.49) μmol/L,P<0.05］;软斑块组（n=11）的血清UA水平较硬斑块组（n=34）显著增高［（389.00±69.45) μmol/L vs (323.03±72.71) μmol/L,P<0.05］。多元线性逐步回归分析显示CFPWV与年龄（r=0.414）、收缩压（r=0.224）、脉压（r=0.270）和血清UA（r=0.219）呈显著正相关（P<0.05）。结论：血清UA水平增高是EH发病的危险因素之一,血清UA水平可反映颈动脉斑块的严重程度及稳定性,EH患者随着血清UA水平增高大动脉弹性减退。     

Polymorphism of Serotonin Receptor Genes (5-HTR2A) and Dysbindin (DTNBP1) and Individual Components of Short-Term Verbal Memory Processes in Schizophrenia

Associations between polymorphisms in the T102C and A-1438G loci of the 5-HTR2A and the P1763 and P1578 markers of the DTNBP1 gene with the overall productivity and individual subprocesses of shortterm verbal memory were studied in 4–5 patients with schizophrenia and 290 healthy subjects. Subjects were asked to reproduce immediately two lists of 10 words. The overall productivity of reproduction was assessed, along with the reproduction productivity of the first list (immediate memory or general attention), the effect of proactive interference, and the number of intrusions. Patients were significantly different from controls on all measures. Patients showed decreases in overall task performance productivity, in immediate memory productivity, and in the effect of proactive interference; fewer intrusions were seen. Both markers of the 5-HTR2A gene were associated with short-term memory productivity in the combined cohort: assessments were worse in T102C CC and A-1438G GG homozygotes. The P1763 marker of the DTNBP1 gene, conversely, had significant influences on the memory subprocesses reflected in the levels of interference and intrusions but had insignificant influence on overall productivity. Homozygotes for P1763G GG had the worst parameters. Overall, these data are consistent with the concept that these polymorphic genes are involved in different subprocesses of short-term memory both in normal subjects and in patients with schizophrenia.