AGEs与NO在尿毒症心血管并发症中的变化及意义

目的 探讨尿毒症时AGEs与NO的关系,以及AGEs与NO在尿毒症心血管并发症中的意义.方法 用ELISA法检测研究对象血中AGEs的水平,用硝酸还原酶法检测研究对象血中NO含量.结果 ①血清AGEs水平高于健康对照组,且有心血管并发症组AGEs明显高于无心血管并发症组.②血清NO水平低于健康对照组,且有心血管并发症组NO明显低于无心血管并发症组.③AGEs与NO呈负相关.结论 血中高浓度的AGEs可能通过灭活NO等机制与NO共同参与尿毒症心血管并发症的发生发展.     

碳酸酐酶Ⅲ与老年2型糖尿病性血管病变的相关性分析

目的:分析老年糖尿病性血管病变的可能危险因素,探讨碳酸酐酶Ⅲ(CAⅢ)与老年糖尿病性血管病变的相关性。方法:筛选2017年复旦大学附属华山医院老年病科门诊体检的老年人群,观察糖尿病患者血管并发症的发生情况及相关血清生化指标的变化。按照入组标准和排除标准分为3组:对照组、T2DM未合并血管并发症组及T2DM合并血管并发症组。所有老年人群除进行常规体检筛查外,采用ELISA法检测血清CAⅢ水平。结果:与对照组相比,T2DM组ALT、TP、BUN、UA、TG、LDL、HDL、FBG、HbA1c差异均存在统计学意义(P0.05)。T2DM组合并血管并发症组患者体内TBIL水平明显低于无血管并发症组(P0.05)。ELISA检测结果显示T2DM未合并血管并发症和合并血管并发症组患者体内CAⅢ水平均明显低于对照组(P0.01),且T2DM合并血管并发症组CAⅢ水平低于未合并血管并发症组(P0.01)。Spearman相关系数分析显示:血清CAⅢ水平与HDL、TBIL正相关,但差异无统计学意义;血清CAⅢ水平与LDL、Scr、BUN、FBG、HbA1c负相关,且与BUN、FBG和HbA1c间的关联性较大(P0.05)。ROC曲线分析提示CAⅢ对诊断T2DM合并血管并发症的敏感性和特异性均较好(P0.05)。结论:血清CAⅢ水平与老年T2DM性糖脂代谢紊乱及其血管并发症密切相关,CAⅢ可能通过调控糖脂代谢来参与老年糖尿病性血管病变的发生和发展。     

糖尿病患者血清可溶性白细胞介素-2受体水平及临床意义

采用ELISA法对68例糖尿病（DM）患者血清可溶性白细胞介素-2受体（SIL－ZR）水平检测．其中非胰岛素依赖型糖尿病（NIDDM）48例、胰岛素依赖型糖尿病（IDDM）20例。结果发现NIDDM、IDDM组血清SIL－2R均高于正常对照组，且IDDM组比NIDDM组升高更明显。合并血管并发症级明显高于无血管并发症组。血清SIL－2R与病程呈正相关。随着病情好转，空腹血糖下降，血清SIL－2R呈下降趋势。结果表明SIL－2R可能与DM发病有相关性。DM发病过程中存在免疫调节障碍。血清SIL－2R升高与病情发展有关。动态检测血清SIL－2R水平可能成为临床上观察DM病情变化的客观指标。     

2型糖尿病周围神经病变一氧化氮及内皮素水平的测定

目的:探讨血清一氧化氮(NO)及血浆内皮素(ET)水平在2型糖尿病周围神经病变患者中的变化。方法:选取2型糖尿病住院患者60例,其中糖尿病合并周围神经病变患者30例,无周围神经病变患者30例,另选健康对照组24例,采用放射免疫法分别测定其血浆ET水平和酶法测定血清NO水平。结果:糖尿病周围神经病变组NO水平显著低于糖尿病无并发症组(P<0.001),后者NO水平显著低于健康对照组(P<0.001);糖尿病周围神经病变组ET水平显著高于无并发症组(P<0.001),后者ET水平显著高于健康对照组(P<0.001);相关分析显示NO与ET呈负相关,r=-0.795,P<0.001。结论:正常人以及糖尿病无并发症组相比,一氧化氮及血浆内皮素的水平在2型糖尿病周围神经病患者中有明显变化。     

碳酸酐酶Ⅲ与老年糖尿病性血管病变相关性的临床观察研究

目的：分析老年糖尿病性血管病变的可能危险因素，探讨CAⅢ与老年糖尿病性血管病变之间的内在相关性。方法：筛选2017年复旦大学附属华山医院老年病科门诊体检的老年人群，观察糖尿病患者血管并发症的发生情况，以及相关血清生化指标的变化。按照入组标准和排除标准分为三组：对照组，T2DM未合并血管并发症组和T2DM合并血管并发症组。所有老年人群除进行常规体检筛查以外，还需要ELISA法检测血清CAⅢ水平。采用SPSS 25.0统计软件分析数据。结果：与对照组相比，T2DM组的ALT、TP、BUN、UA、TG、LDL、HDL、FBG、HbAlc均存在显著差异（P<0.05）。T2DM组中有血管并发症患者体内的TBIL水平明显低于无血管并发症者（P<0.05）。ELISA检测结果显示T2DM未合并血管并发症和合并血管并发症组患者体内CAⅢ水平均明显低于对照组（P均<0.01），而且T2DM合并血管并发症组CAⅢ水平更低于未合并血管并发症组（P<0.01）。Spearman相关系数分析显示血清CAⅢ水平与HDL和TBIL正相关，但无统计学意义；血清CAⅢ水平与LDL、Scr、BUN、FBG、HbA1c负相关，但与BUN、FBG和HbA1c之间的关联性较大（P<0.05）。ROC曲线分析提示CAⅢ对诊断T2DM合并血管并发症的敏感性和特异性均较好（P<0.05）。结论：血清CAⅢ水平与老年T2DM性糖脂代谢紊乱及其血管并发症密切相关，提示CAⅢ可能是通过调控糖脂代谢等机制来参与老年糖尿病性血管病变的发生和发展进程，但其内在机制尚有待进一步深入研究。     

2型糖尿病合并周围神经病变内皮素及一氧化氮水平监测

目的探讨血浆内皮素(ET)及血清一氧化氮(NO)在2型糖尿病合并周围神经病变时的浓度变化。方法糖尿病合并周围神经病变组36例,糖尿病无周围神经病变组30例,正常对照组30例。结果DPN组ET水平显著高于DM组(P<0·001),DM组ET水平显著高于正常对照组(P<0·001)。DPN组NO水平显著低于DM组(P<0·001),DM组NO水平显著低于正常对照组(P<0·001)。直线相关分析显示ET与NO呈负性相关。结论ET、NO的检测作为血管内皮受损的指标,对DPN的发生及病情的判断有参考价值。     

非对称性二甲基精氨酸与2型糖尿病及其大血管并发症关系的研究

目的 研究血清非对称性二甲基精氨酸(ADMA)与2型糖尿病及其大血管并发症的关系,观察强化治疗对ADMA水平的影响.方法 2型糖尿病患者97例(DM组),包括无大血管并发症亚组(DM1亚组)22例和伴大血管并发症亚组(DM2亚组)75例.所有患者均入院接受降糖和(或)降压、调脂等强化治疗2周,并于2个月后对患者进行随访.选取40例健康体检者作为正常对照组(NC组).用酶联免疫法(ELISA)检测血清ADMA水平及生化仪器检测其他相关指标.用SPSS 12.0软件包进行分析.结果 2型糖尿病两个亚组血清ADMA水平均明显高于正常对照组(P<0.05),且2型糖尿病伴大血管并发症亚组平均血清ADMA水平高于2型糖尿病无大血管并发症亚组(P<0.05).多元线性回归分析显示,在2型糖尿病组(DM组)中糖化血红蛋白(HbA1c)、总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)均与ADMA水平呈正相关.经强化治疗后其血清ADMA水平明显下降(P<0.05).结论 血清ADMA水平与2型糖尿病及其大血管并发症密切相关,与HbA1c、TC和LDL-C均呈正相关.强化治疗可以使2型糖尿病患者血清ADMA水平明显下降.     

血清空腹C肽水平与2型糖尿病周围血管并发症相关性

目的:探讨血清空腹C肽与2型糖尿病周围血管并发症的关系。方法:糖耐量异常患者(IGT组)72例,2型糖尿病患者(T2DM组)140例,同期健康体检者50名为对照组(NC组)。T2DM组根据有无冠心病再分为糖尿病合并周围血管并发症组(T2DM合并PVD组)68例,糖尿病无周围血管并发症组(T2DM无PVD组)72例,比较各组血清空腹C肽、血脂、空腹血糖等指标。结果:T2DM组血清空腹C肽高于IGT组、NC组(P<0.05);T2DM合并PVD组血清空腹C肽水平低于T2DM无PVD组(P<0.05);IGT组血清空腹C肽水平高于NC组,但差异无统计学意义(P>0.05)。T2DM合并PVD与空腹C肽、年龄、糖尿病病程、空腹血糖相关(P<0.01)。结论:糖尿病合并周围血管并发症的发生与发展除与年龄、糖尿病病程、空腹血糖等有关外,还可能与空腹C肽水平有关,血清空腹C肽可能成为糖尿病周围血管病变的早期预测指标。     

血清sVCAM-1水平与2型糖尿病脑梗死关系探讨

目的:探讨血清中可溶性血管细胞黏附分子-1(sVCAM-1)水平与2型糖尿病(T2DM)患者并发脑梗死的关系探讨。方法:应用ELISA法检测了68例T2DM患者血浆sVCAM-1水平,并且与20例健康人作对照。结果:T2DM各组血清sVCAM-1水平明显高于健康对照组(P<0.01);无脑梗死组、小灶性脑梗死组、大面积脑梗死组含量逐步升高(P<0.01);血清sVCAM-1水平与LDL-C、TG、TC呈正相关(P<0.05)。结论:血清sVCAM-1参与2型糖尿病脑血管并发症的发生与发展,可作为早期2型糖尿病脑血管并发症发生的预测及检测指标。     

血清空腹C肽水平与2型糖尿病周围血管并发症相关性

目的:探讨血清空腹C肽与2型糖尿病周围血管并发症的关系.方法:糖耐量异常患者(IGT组)72例,2型糖尿病患者(T2DM组)140例,同期健康体检者50名为对照组(NC组).T2DM组根据有无冠心痛再分为糖尿病合并周围血管并发症组(T2DM合并PVD组)68例,糖尿病无周围血管并发症组(T2DM无PVD组)72例,比较各组血清空腹C肽、血脂、空腹血糖等指标.结果:T2DM组血清空腹C肽高于IGT组、NC组(P＜0.05);T2DM合并PVD组血清空腹C肽水平低于T2DM无PVD组(P＜0.05);IGT组血清空腹C肽水平高于NC组,但差异无统计学意义(P＞0.05).T2DM合并PVD与空腹C肽、年龄、糖尿病病程、空腹血糖相关(P＜0.01).结论:糖尿病合并周围血管并发症的发生与发展除与年龄、糖尿病痛程、空腹血糖等有关外,还可能与空腹C肽水平有关,血清空腹C肽可能成为糖尿病周围血管痛变的早期预测指标.     

Measurement of L-carnitine and acylcarnitines in body fluids and tissues in children and in adults

We have developed a reliable and validated radio-enzymatic method for the assay of L-carnitine and acylcarnitines, using a modification of existing methods. The sensitivity of the assay is 10 mumol/l using 10 microliters of plasma or urine. It is also suitable for measurements of carnitine in a 10 mg sample of liver or muscle obtained by percutaneous biopsy. The use of N-ethylmaleimide in the reaction mixture together with an excess of [1-14C]acetyl CoA ensures that the reaction proceeds to completion and a linear response is obtained. Using this method control ranges have been established for plasma and urine carnitine concentrations in healthy children and adults, and for the carnitine content of liver and muscle in adults. No significant difference was found between fasting and post-prandial plasma carnitine levels. An age-related increase was found in urinary total carnitine and acylcarnitine concentration throughout childhood. These data provide a reliable basis for studies of patients with abnormal carnitine and acylcarnitine metabolism, distribution and excretion.     

Rosamicin in Urethral and Vaginal Secretions and Tissues in Dogs and Rats

In animal studies we investigated the distribution of rosamicin in plasma and urethral and vaginal tissues in rats as well as in urethral and vaginal secretions in dogs. We found concentration ratios between urethral secretion and plasma of 1.9 and between vaginal secretion and plasma of 2.4. The rosamicin concentrations in urethral and vaginal tissue significantly exceeded the levels of all other tissues investigated. Because rosamicin could be valuable for the treatment of bacterial urethritis and the colonization of the vaginal introitus with fecal bacteria in women, it should be investigated clinically in this respect.     

Similarities and differences in clients treated and in medications prescribed by APRNs and psychiatrists in a CMHC

This study is part of a larger study comparing prescribing practices of psychiatrists and advanced practice psychiatric nurses (APRNs) using the following three groups of patients: patients treated by psychiatrists, those treated by APRNs, and those treated by both APRNs and psychiatrists at different times in 1 year. Demographics for 5507 patients were examined. A subsample of APRNs and psychiatrists prescribed similar total numbers of medications. Psychiatrists prescribed more types of antidepressant medications other than the SSRI antidepressants, and they prescribed more than twice the number of benzodiazepines. APRNs prescribed more SSRIs and spent more time with clients during medication visits.     

Racial differences in oxidative stress and inflammation: in vitro and in vivo

African American race is an independent risk factor for enhanced oxidative stress and inflammation. We sought to examine whether oxidative-stress and inflammatory markers that are typically measured in humans also differ by race in cell culture. We compared levels between African American and Caucasian young adults and then separately in human umbilical vein endothelial cells (HUVECs) from both races. We found heightened oxidative stress and inflammation in the African Americans both in vitro and in vivo. African American HUVECs showed higher nitric oxide (NO) levels (10.8 ± 0.4 vs. 8.8 ± 0.7 μmol/L/mg, p = 0.03), Interleukin-6 (IL-6) levels (61.7 ± 4.2 vs. 23.9 ± 9.0 pg/mg, p = 0.02), and lower superoxide dismutase activity (15.6 ± 3.3 vs. 25.4 ± 2.8 U/mg, p = 0.04), and also higher protein expression (p < 0.05) of NADPH oxidase subunit p47phox, isoforms NOX2 and NOX4, endothelial nitric oxide synthase (NOS), inducible NOS, as well as IL-6. African American adults had higher plasma protein carbonyls (1.1 ± 0.1 vs. 0.8 ± 0.1 nmol/mg, p = 0.01) and antioxidant capacity (2.3 ± 0.2 vs. 1.1 ± 0.3 mM, p = 0.01). These preliminary translational data demonstrate a racial difference in HUVECs much like that in humans, but should be interpreted with caution given its preliminary nature. It is known that racial differences exist in how humans respond to development and progression of disease, therefore these data suggest that ethnicity of cell model may be important to consider with in vitro clinical research.     

Postural strategies and falls in elderly and in parkinsonism]

OBJECTIVE: To use a posture analysis to show the evolution of postural pattern connected with falls.MATERIAL AND METHOD: It is a prospective study on two groups of 16 persons of more than 60 years. A group concerns 16 small disability off drug parkinsonian patients, a group concerns 16 healthy witnesses. All the persons benefited from a posture recording by means of a force platform and were followed during 1 year. RESULTS: Data analysis underlines three groups of persons corresponding to three postural patterns, independently of the presence of Parkinson disease. A group (n = 18) did not contain fallers, the second (n = 10 ) contained 20% of fallers, the third (n = 4) contained 100% of fallers. Differences between the groups were identified on 16 posturographic parameters. DISCUSSION: A group has a good functional value and one does not record any fall. Its characteristics, which correspond to a category of persons who compensate well for the phenomena of ageing, are found in the literature. A group has an intermediate functional value and regrets 20% of fallers. Kinetic profile reveals a tendency to the stiffness of the posture. This group is going to operate rather ankle strategies. A group has an inferior functional value and regrets 100% of fallers. Kinetic profile seems disrupted and not to be able to adapt itself in a satisfactory way to the situation otherwise than by stereotypical reactions. This group is going to operate systematically much less stabilizing hip strategies. CONCLUSION: A close determinism between physiological neuromotor ageing and Parkinson disease does exist. We showed with a prospective follow-up, the arisen of fall and showed the evolution of postural patterns related to fall. It appears as well that evolution mainly follows three stages leading from a small risk of fall gait pattern to a major risk of fall gait pattern.