组蛋白修饰在糖尿病发病中的作用

组蛋白修饰是一种重要的表观遗传学现象,对基因表达调控发挥着至关重要的作用。一般认为糖尿病是一种由环境因素、遗传因素及免疫因素等共同作用的代谢性疾病,其发病机制主要与胰岛素抵抗、胰岛素分泌不足及免疫炎症等密切相关。目前,糖尿病的发病机制尚未完全清楚,治疗中也有一定局限性。但有研究表明组蛋白修饰与糖尿病的发病有密切关系。     

表观遗传学与疾病发生发展的研究进展

近年研究发现,表观遗传学会导致基因表达的持续性改变,它是疾病发生的重要机制。表观遗传学与众多疾病,包括肿瘤、糖尿病、神经精神疾病、自身免疫病、衰老、老年性疾病等的发生发展密切相关。表观遗传学主要有以下调控方式:DNA甲基化、组蛋白修饰、非编码RNA等机制。表观遗传学的研究将为研究疾病发生发展提供新视角,并为疾病临床治疗研究提供新方向和新思路。本文将对近年来表观遗传学研究进展作系统的综述。     

DNA和组蛋白表观遗传修饰在2型糖尿病发病中作用的研究进展

糖尿病是由遗传和环境因素相互作用而引起的代谢性疾病。表观遗传修饰被证实与糖尿病发病有关。表观遗传修饰包括DNA甲基化、组蛋白修饰和非编码RNA等。表观遗传通过DNA甲基化、组蛋白乙酰化和甲基化修饰等方式影响生命活动,其变化会影响糖尿病的发生发展。环境因素可以通过影响DNA甲基化及组蛋白修饰明显增加2型糖尿病的患病风险。DNA甲基化异常通过影响炎症反应和干扰胰岛的分泌从而导致糖尿病。组蛋白的翻译后修饰主要分为组蛋白的甲基化和乙酰化,通过作用于炎症反应、胰岛β细胞发育和胰岛素表达,从而影响糖尿病的发生发展。本文作者对2型糖尿病中可能的表观遗传学DNA甲基化和组蛋白修饰机制进行综述。     

灵芝多糖对妊娠期糖尿病大鼠血糖及胰岛素水平的影响

目的：探讨灵芝多糖对妊娠期糖尿病大鼠的降糖作用及机制。方法：将24只大鼠随机分为正常对照组、妊娠期糖尿病模型组、灵芝多糖治疗组。分别检测0、7、14 d空腹血浆血糖和胰岛素水平。结果：与妊娠期糖尿病模型组比较,灵芝多糖治疗组大鼠空腹血糖明显降低、胰岛素水平显著增高（P〈0.01）。结论：灵芝多糖具有治疗妊娠期糖尿病大鼠的作用,其机制可能和上调胰岛素水平有关。     

表观遗传学与糖尿病肾病的研究进展

表观遗传学(epigenetics)最早在1942年由康拉德·哈尔·沃丁顿提出,是指在DNA序列不发生变化但基因表达的水平和功能却发生了可遗传的改变,从而引起相应的病理生理变化,其与肿瘤、心血管、代谢综合征、糖尿病等多种疾病的发生发展有关。主要包括DNA甲基化和染色质构象的改变,微小RNA干扰等。糖尿病是世界第三大慢性疾病,严重危害着人类健康。特别是糖尿病肾病,即使血糖控制在理想状态下,其肾脏的各种病理变化仍能持续发生,这种现象提示存在"代谢记忆",有研究指出可从表观遗传学水平阐明其发病机制。本文重点从DNA甲基化和组蛋白修饰这两个方面进行讨论表观遗传学与糖尿病肾病之间的关系,就表观遗传学在糖尿病肾病中的研究进展进行综述。     

针刺对糖尿病模型大鼠血浆神经肽 Ｙ的影响

目的：观测针刺对链脲左菌素（sterptozotcin,STZ）诱导的糖尿病模型大鼠血浆神经肽 Ｙ（neurpeptideＹ,ＮＰＹ）的影响。方法：ＳＴＺ诱导的糖尿病模型大鼠随机分为模型组、治疗组、防治组,其余正常大鼠作为对照组,每组10只。防治组于造模前１周开始针刺预防,取穴双侧“后三里”、胰俞穴,每日 １次,共治疗 １４次。治疗组大鼠取穴同防治组大鼠,于造模后第 １天给予针刺治疗,每日针刺 １次,共 ７次。疗程结束后用血糖仪检测大鼠空腹血糖,用放射免疫分析法检测大鼠胰岛素和 ＮＰＹ。结果：与模型组比较,针刺治疗和防治明显降低糖尿病大鼠的血糖水平（Ｐ＜0.05）,升高胰岛素水平（Ｐ＜0.05）,降低 ＮＰＹ水平（Ｐ＜0.05）;且防治组效果优于治疗组（Ｐ＜0.05）。结论：针刺降低糖尿病大鼠血糖的同时使胰岛素、ＮＰＹ水平降低,可能是针刺防治糖尿病血管并发症的机制之一;针刺防治结合效果优于单纯的针刺治疗。     

精神分裂症的表观遗传学机制及其相关药物的研究进展

目的 为药物治疗精神分裂症提供新的优化治疗方案。方法 介绍近年来具有表观遗传学作用特点的抗精神病药物的研究进展。 结果 有3种药物包括丙戊酸是目前具有表观遗传学作用机制的抗精神病药物。结论 应重视联用具有表观遗传学作用的抗精神病药物治疗难治性精神分裂症。     

表观遗传学修饰在多发性硬化症中作用的研究进展

多发性硬化症既是经典的神经免疫性疾病,又是神经退行性疾病。越来越多的证据表明,表观遗传学改变与多发性硬化症的发病相关。表观遗传学修饰可以影响基因的表达,但不会改变DNA的序列。DNA甲基化、组蛋白修饰和微小RNA相关基因转录和翻译的调控是表观遗传的3种重要机制。表观遗传学可能通过调节多发性硬化症的病因（包括遗传易感性和环境危险因素）和发病机制（包括炎症脱髓鞘和神经退行性变化的机制）的多个环节影响多发性硬化症的发病。本文综述了表观遗传学修饰在多发性硬化症发生中的作用,并为从表观遗传学角度治疗多发性硬化症提出建议。     

表观遗传学、环境与2型糖尿病之间的关系

2型糖尿病（T2DM）是由基因和环境相互作用引起的代谢紊乱,其特点是胰岛素抵抗和胰岛β细胞功能障碍,截至目前T2DM发病机制尚不清楚.尽管通过遗传学手段已经证实机体细胞内确有能导致个体间T2DM易感性不同的基因,但由于基因组结构的稳定性,大多数环境因素并不能引起基因突变或DNA序列改变,单纯从基因角度无法解释不断迅速增长的T2DM发生率.环境与生活方式作为T2DM发病的重要因素,可通过表观遗传学的各种机制调节基因的表达,最终传达到表型性状,因此表观遗传学在2型糖尿病的发病过程中的作用逐渐得到重视.     

宫内和出生后早期发育环境对成年期糖代谢影响的中枢调控作用机制

目前有大量证据表明早期不良的发育环境对成年期增加代谢性疾病的易感性起着决定性的作用。另外,随着人们对中枢胰岛素抵抗的认识增加,中枢对调控外周葡萄糖稳态起着极其重要的作用,越来越多的研究表明这可能是一种表观遗传学机制。表观遗传学是研究在没有DNA序列变化的情况下,引起基因表达可遗传性的改变。它能特异性地调节相关组织的基因表达,从而诱导物质代谢长期的改变。本文着重探讨早期发育环境对成年期糖代谢影响的中枢调控作用的表观遗传学机制。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.