高原心肌低氧症患者血浆肾素系统和心钠素的变化

为研究高原心肌低氧症患者血浆肾素系统和心钠素的变化，对３０例高原心肌低氧症（ＨＡＭＨ）患者用放免法测定了血浆肾素活性（ＰＲＡ）、血管紧张素ＩＩ（ＡＩＩ）、醛固酮和心钠素（ＡＮＦ）含量，结果发现ＨＡＭＨ患者血浆ＡＩＩ与ＡＮＦ间浓度比例与慢性高原心脏病、长期移居高原健康成人明显不同。并讨论了这些生物活性物质紊乱可能在ＨＡＭＨ发生发展中的作用。     

清醒狗中心外膜ST段抬高和局部心肌血流及心肌梗塞范围之间的关系

本文旨在评价冠状动脉持续闭塞15分钟及2小时后,心外膜ST段改变与心肌梗塞范围及局部心肌血流量之间的关系。心肌梗塞的范围是在闭塞后6天,当完整心肌与梗塞心肌呈明显分界时,用连续组织切片法测定。局部心肌血流量则用放射性同位素标记微球法测定。     

自发性高血压大鼠心肌胶原增生与心肌局部血管紧张素II及醛固酮

目的 为探讨高血压大鼠（ＳＨＲ）心肌胶原增生与心肌局部血管紧张素Ⅱ（ＡｎｇⅡ）、醛固酮（Ａｌｄ）的关系。 方法 应用羟脯氨酸法测定大鼠心肌胶原含量，用放免法测定心肌局部ＡｎｇⅡ、Ａｌｄ含量，将两者进行线性相关分析。 结果 自发性高血压大鼠（ＳＨＲ ｎ＝７）与对照组（ＷＫＹｎ＝７）与对照组（ＷＫＹｎ＝７）相比，心肌胶原含量增加（Ｐ〈０．０１）。相关分析表明，心肌胶原含量与心肌局部ＡｎｇⅡ含量呈正相关     

粒细胞集落刺激因子在急性心肌梗死治疗中的作用

急性心肌梗死（acute myocardial infarction．AMI）发病率、致残率和死亡率高,严重危害健康。由于成人体内心肌细胞缺乏再生能力,心肌梗死的坏死区将由结缔组织替代,梗死周围心肌重新排列重构心肌,并最终发展为心力衰竭。心力衰竭是AMI患者死亡的主要原因,目前治疗药物和介入疗法无法逆转已坏死的心肌细胞。     

曲尼司特对急性心肌梗死大鼠心肌纤维化的影响

目的:观察曲尼司特对大鼠急性心肌梗死(AMI)后心肌纤维化和左室功能的影响。方法:结扎大鼠 冠状动脉制成AMI模型,随机分成假手术组(6只)、AMI组(8只)、曲尼司特组(7只)和苯那普利组(6只)。于 第4周末,用放射免疫法测定血浆和心肌血管紧张素Ⅱ含量,用氯胺T法测定羟脯氨酸含量,动脉插管测定大鼠 左室心功能。结果:与AMI组比较,曲尼司特不能降低血浆和心肌血管紧张素Ⅱ水平,但能减少非梗死区心肌羟 脯氨酸含量,降低左室舒张末压,升高±dp/dt。结论:曲尼司特可减轻AMI后左室心肌纤维化,改善左室功能。     

两维超声心动图测定正常人左室肌重量及左室容量与心肌重量之比值

本文报道两维超声心动图测定成人左室肌重量(LVM),左室舒张末和收缩末容量与心肌重量之比值(LVVd/M,LVVs/M)的正常值范围。方法:从医院雇员中随机选择无心血管病史、血压和心电图正常的健康成人84(男44,女40)例作为研究对象,平均年龄36±11(20～66)岁。应用相控阵扇超仪和2.25MHz 探头,图象记录在录象带上,再用计算机光笔系统进行分析。左室可看作截取     

用原位核酸杂交法探讨柯萨奇病毒与克山病的关系

为进一步探讨柯萨奇病毒与克山病的关系，采用柯萨奇Ｂ３病毒（ＣＶＢ３）制备的ｃＤＮＡ探针与黑龙江、山东、云南三省病区克山病尸检心肌组织及胎儿克山病心肌组织的石蜡切片进行了原位核酸杂交，并用脑外伤、ＣＯ中毒等意外死亡健康成人及冠心病、风心病尸检心肌组织和病区、非病区７～８个月引产胎儿心肌组织的石蜡包埋切片作为对照。结果急型克山病８／１３、慢型克山病３４／５０、亚急型克山病２２／２９呈现阳性杂交信号，提示有柯萨奇病毒ＲＮＡ的存在，冠心病２／１５、风心病１／１５、显著低于克山病，而健康成人对照组均为阴性，胎儿克山病一例呈阳性反应，病区引产胎儿心肌组织１０例中有２例也检出柯萨奇病毒ＲＮＡ，而非病区胎心则为阴性。结果提示在一些克山病的发生和发展过程与柯萨奇Ｂ组病毒的感染高度相关。     

速度向量成像技术对正常1至3个月龄婴儿与成年人心肌功能对比性研究

目的:应用速度向量成像技术(VVI)分析正常1~3个月龄婴儿,与正常成人心脏左心室各节段室壁心肌纵向收缩功能,为进一步评价该月龄婴儿的心肌功能提供理论依据。方法:选取2014年8月至2015年10月期间,在我院进行体检的正常成年人43例,正常1~3个月龄婴儿30例。采集并存储心尖段四腔心切面,应用软件描记分析,获得左心室壁基底段、中间段及心尖段心肌纵向应变及应变率。结果:1~3个月龄婴儿与成人左心室侧壁基底段、中间段、心尖段、室间隔基底段、中间段及心尖段心肌纵向应变,差异有统计学意义(P0.05);纵向应变率差异无统计学意义(P0.05)。结论:正常1~3个月婴儿左心室壁心肌的纵向应变与成人左心室壁心肌纵向应变不同,该月龄婴儿心肌未发育到成人心肌程度。VVI技术可以客观分析该阶段婴儿的局部心肌纵向运动功能,并且便捷、准确的为临床判断其心脏功能提供依据。     

磁场对克山病心肌的保护作用——磁场对缺氧性心肌损伤大鼠血红细胞SOD活性及血浆MDA含量变化的影响

本实验将大鼠随机分为4组:空白对照组、磁作用对照组、缺氧性心肌损伤组、缺氧性心肌损伤磁场治疗组。分别采用四氮唑蓝法和硫代巴比妥酸法测定各组大鼠血红细胞SOD活性及血浆MDA含量。结果表明:血红细胞SOD活性,缺氧性心肌损伤磁场治疗组明显高于缺氧性心肌损伤组(P<0.01),磁作用对照组高于空白对照组(P<0.05)。血浆MDA含量,缺氧性心肌损伤磁场治疗组明显低于缺氧性心肌损伤组(P<0.01)。初步证实,磁砀对缺氧性心肌损伤大鼠和健康大鼠心肌具有一定的保护作用,此种作用对缺氧性心肌损伤大鼠更为明显。提示:磁场对克山病心肌具有一定的保护作用。     

心脏X综合征患者内皮素-1、内皮素-1／NO比值与心肌灌注显像的相关性研究

本研究旨在观察心脏X综合征患者静息状况下和运动负荷时内皮素 1(ET 1)、一氧化氮(NO)含量及其平衡关系变化与心肌血流灌注异常之间的相互关系。一、对象与方法选取确诊的心脏X综合征患者(A组) 14例,健康体检者(B组) 15例作为对照。两组均在静息时和运动高峰时抽取静脉血,分别采用放射免疫法和硝酸还原酶法测定血浆ET 1、NO水平。通过核素心肌灌注显像,用半定量分析方法评价其心肌灌注情况。将测得的ET 1、ET 1/NO比值与心肌灌注异常总评分进行直线相关分析。二、结果1.两组运动前后ET 1、ET 1/NO比值变化:见表1。表1　两组患者运…     

1H-MRS in autism spectrum disorders: a systematic meta-analysis

We conducted a systematic review and meta-analysis of proton magnetic resonance spectroscopy (1H-MRS) studies comparing autism spectrum disorder (ASD) patients with healthy controls, with the aim of profiling ASD-associated changes in the metabolites N-acetyl-aspartate (NAA) and Creatine (Cr). Meta-regression models of NAA and Cr levels were employed, using data from 20 eligible studies (N = 852), to investigate age-dependent differences in both global brain and region-specific metabolite levels, while controlling for measurement method (Cr-ratio versus absolute concentrations). Decreased NAA concentrations that were specific to children were found for whole-brain grey and white matter. In addition, a significant decrease in NAA was evident across age categories in the parietal cortex, the cerebellum, and the anterior cingulate cortex. Higher levels of Cr were observed for ASD adults than children in global grey matter, with specific increases for adults in the temporal lobe and decreased Cr in the occipital lobe in children. No differences were found for either NAA or Cr in the frontal lobes. These data provide some evidence that ASD is characterized by age-dependent fluctuations in metabolite levels across the whole brain and at the level of specific regions thought to underlie ASD-associated behavioural and affective deficits. Differences in Cr as a function of age and brain region suggests caution in the interpretation of Cr-based ratio measures of metabolites. Despite efforts to control for sources of heterogeneity, considerable variability in metabolite levels was observed in frontal and temporal regions, warranting further investigation.     

Urinary excretion of pyridinium cross-links in healthy women; the long-term effects of menopause and oestrogen/progesterone therapy

OBJECTIVES We investigated the effect of the menopause when followed longitudinally for a decade to evaluate whether women with an increased bone loss continue to have elevated urinary excretion of pyridinium cross-links later in menopause. Furthermore, we investigated the effect of oestrogen/progesterone therapy on the urinary excretion of pyridinium cross-links. PARTICIPANTS In the cross-sectional study: 18 healthy premenopausal, 142 healthy post-menopausal women and 41 osteopenic post-menopausal women. In the longitudinal study: 45 healthy post-menopausal women followed up for 7-10 years after the menopause; these women were further divided into two equal groups, according to their loss of forearm bone mineral content over 2 years. In the oestradiol/progesterone double-blind, placebo-controlled 2-year trial: early post-menopausal women were given either hormone replacement therapy (n = 38) or placebo (n= 16). MEASUREMENTS The urinary excretion of pyridinoline/ creatinine (Pyr/Cr) and urinary deoxypyridinoline/creatinine (D-Pyr/Cr), two new markers of bone resorption. RESULTS Pyr/Cr and D-Pyr/Cr increased significantly after the menopause (Pyr/Cr, 77%; D-Pyr/Cr, 98%, P < 0.001). Hormone replacement therapy reversed this increase towards premenopausal levels. Both pyridinium cross-links remained fairly constant during the first decade of the menopause, when measured in the longitudinal study. When the women were divided according to loss in forearm BMC., those with a loss greater than 3-5%/2 years had significantly higher levels of pyridinium cross-links (P<0.05-0 01). Furthermore, both Pyr/Cr and D-Pyr/Cr were significantly higher in elderly osteopenic women (aged 68-72 years) than in age-matched non-osteopenic women (P<0.01-0.001). CONCLUSIONS Both Pyr/Cr and D-Pyr/Cr, two new markers of bone resorption, increased significantly at the time of the menopause, thereafter remaining fairly constant during the first post-menopausal decade. Women with increased bone loss continue to have elevated urinary excretion of pyridinium cross-links during the first decade of the menopause. This post-menopausal change is reversed by hormone replacement therapy to the premenopausal level.     

慢性饮水型砷暴露对人体DNA氧化损伤的影响

目的 评价慢性饮水型砷暴露及暴露时间对人体DNA氧化损伤的影响.方法 采用横断面研究对108名慢性饮水型砷暴露居民和75名对照居民进行调查;采用队列研究对64名慢性饮水型砷暴露者分别于砷暴露7年和9年时进行调查.用ELISA法测定尿8-羟基脱氧鸟苷(8-OHdG)水平,氢化物发生原子吸收分光光度法检测尿砷.结果 横断面研究中,砷暴露组尿砷中位数为484.17 mg/kg Cr,对照组为13.80 mg/kg Cr,两组比较差异有统计学意义(t=32.566,P<0.01);儿童、成人尿8-OHdG中位数分别为16.60、21.88 mg/kg Cr,明显高于对照组儿童(10.50 mg/ks Cr)和成人(9.11 mg/kg Cr),组间两两比较,差异有统计学意义(t值分别为5.049、6.913.P<0.01);暴露组儿童8-OHdG水平明显低于成人(t=-1.997,P<0.05).队列研究中,砷暴露7年时尿砷中位数为461.31 mg/kg Cr,暴露9年时为422.90 mg/kg Cr,二者比较未见明显差异(t=-0.250,P0.05);砷暴露9年时儿童与成人尿8-OHdG中位数分别为23.46、24.30 mg/kg Cr,与暴露7年时(14.29、18.38 mg/kg Cr)比较均明显升高(t值分别为-2.949、-3.055,P<0.01).结论 慢性饮水型砷暴露可导致机体DNA氧化损伤.在一定时期内,机体DNA氧化损伤可能随砷暴露时间的延长而加重.     

Abnormalities in the biochemical markers of bone turnover in children with juvenile chronic arthritis.

OBJECTIVE: To study the biochemical markers of bone turnover in children with juvenile chronic arthritis (JCA) and to compare these parameters with those in healthy children in order to evaluate the relationships between age, disease activity and biochemical variables. METHODS: Sixty-two children with JCA and 157 healthy children were studied. Serum samples were analyzed for their concentrations of minerals, osteocalcin (OC) and bone-specific alkaline phosphatase (BAP). Urine samples were examined to monitor the excretion of hydroxyproline (HYP) and deoxypyridinoline crosslinks (DPD). RESULTS: OC, BAP, HYP/Cr, DPD/Cr values were decreased in healthy girls more than 12 years of age and in healthy boys more than 14 years of age compared to younger children from the same population. Lower levels of OC and BAP were observed in younger children with JCA (girls < or = 12 yrs.; boys < or = 14 yrs.) compared to healthy children of the same age. Older girls with JCA (> or = 13 yrs.) were found to have increased HYP/Cr and DPD/Cr values compared to older healthy children. CONCLUSION: These results indicate that abnormalities of bone metabolism occur in an age-related fashion in JCA. This was demonstrated by a reduction in the markers of bone formation in younger JCA patients. Moreover, in older girls the markers of bone resorption were found to be elevated. Taken together, these findings suggest that bone formation is reduced from early childhood to mid-puberty, while resorption levels increase in children with JCA after this time.     

基底神经节代谢物的质子磁共振波谱增龄变化

目的 探讨基底神经节代谢物N-乙酰天门冬氨酸/胆碱复合物(NAA/Cho)、N-乙酰天门冬氨酸/肌酸(NAA/Cr)和Cho/Cr浓度比值的增龄变化规律. 方法 选择20～87岁健康志愿者70例,男36例,女34例,分为20～40岁、41～59岁和60～87岁者三组,采用磁共振波谱的二维化学位移成像(2D chemical shift imaging,2D CSI)技术检测其大脑双侧豆状核,丘脑及尾状核的代谢物浓度,分析比较不同年龄组的基底神经节代谢物NAA/Cho、NAA/Cr、Cho/Cr浓度比值的变化.结果 双侧豆状核、尾状核、丘脑的NAA/Cho比值及双侧丘脑、右豆状核的NAA/Cr比值与年龄呈负相关(P<0.05),双豆状核的Cho/Cr比值与年龄呈正相关(P<0.05).不同年龄组的NAA/Cho、NAA/Cr、Cho/Cr比值之间差异亦有统计学意义(P<0.05). 结论 健康人的基底神经节代谢物浓度,随其年龄增长而发牛规律性变化,二维化学位移成像是一种检测基底神经节代谢物浓度的无创伤性的方法,是检测正常脑的生理性和病变脑的病理性代谢物浓度变化的重要手段之一.     

Elevated cerebral glutamate and myo-inositol levels in cognitively normal middle-aged adults with metabolic syndrome

Metabolic syndrome (MetS) is a cluster of risk factors associated with significant cardiovascular morbidity and mortality and diminished cognitive function. Given that the cerebral mechanisms mediating the relationship between peripheral metabolic dysfunction and cognitive impairment are unknown, we set out to examine the relationship between diagnosis of metabolic syndrome and cerebral metabolism. Thirteen participants with MetS (aged 48 ± 6 years) and 25 healthy adults (aged 51 ± 6 years) underwent neuropsychological assessment, health screen and proton magnetic resonance spectroscopy (¹H MRS) examining N-acetyl-aspartate (NAA), myo-inositol (mI), creatine (Cr), choline (Cho), and glutamate (Glu) concentrations in occipitoparietal grey matter. Cerebral metabolite ratios (NAA/Cr, Cho/Cr, mI/Cr, and Glu/Cr) of participants with MetS, defined by the International Diabetes Federation criteria, were compared with controls matched for age, education, cognition, and emotional function. There were no significant differences in global cognitive function, memory, language, and psychomotor performance between the groups. Diagnosis of MetS was associated with significantly higher mI/Cr (F(1,36) = 5.02, p = 0.031) and Glu/Cr ratio (F(1,36) = 4.81, p = 0.035). Even in cognitively normal adults, MetS is related to cerebral metabolic disturbances, a possible indication of early brain vulnerability. Longitudinal studies that begin in mid-life can help validate the use of ¹H MRS markers as indicators of long-term cognitive outcomes.     

Platelet protein kinase C isoform content in type 2 diabetes complicated with retinopathy and nephropathy

It has been reported that platelet aggregation in diabetic patients with microangiopathy is increased compared with healthy subjects. Chronic hyperglycemia is known to cause an increase in diacylglycerol level in various tissues. We examine whether protein kinase C (PKC) isoform content in platelets from diabetic patients is increased compared with healthy subjects, as previously described in the retina, aorta, and heart of diabetic rats. Platelet PKCalpha, beta and zeta immunoreactivity in cytosol, membrane and cytoskeleton (CS) fractions were analyzed by immunoblotting in 20 type 2 diabetic patients (who had been treated with diet alone, sulphonylureas or insulin, and whose condition was complicated with retinopathy, nephropathy, neuropathy and/or macroangiopathy) and in five healthy subjects. PKCalpha, beta and zeta immunoreactivity in cytosol, membrane and CS fractions in platelets from diabetic subjects were not significantly higher than those from healthy subjects. However, platelet PKCbeta immunoreactivity in cytosol fraction was significantly higher in diabetic patients with normal serum creatinine (Cr) level than in diabetic patients with abnormal Cr level (Cr > or =1.5 mg/dl) or in healthy subjects. Moreover, significant negative correlation between PKCbeta immunoreactivity in cytosol fraction of platelets and serum Cr level was found in diabetic patients (P < 0.05). To clarify the effect of treatment for diabetes, PKC isoform immunoreactivity in platelets was measured in type 2 diabetic patients treated with diet alone, sulphonylurea or insulin treatment. Serum creatinine level in diabetic patients with insulin treatment was significantly higher than in diabetic patients with sulphonylurea treatment and diet alone. In addition, PKCbeta immunoreactivity in diabetic patients with insulin treatment was significantly suppressed compared with that in patients treated by sulphonylurea treatment. These results suggest that chronic hyperglycemia may activate platelet PKCbeta isoform, and that insulin treatment may decrease platelet PKCbeta activity. Finally, not only PKCbeta antagonists, but also glycemic control by insulin may prevent development of diabetic microangiopathy.     

Platelet protein kinase C isoform content in type 2 diabetes complicated with retinopathy and nephropathy

It has been reported that platelet aggregation in diabetic patients with microangiopathy is increased compared with healthy subjects. Chronic hyperglycemia is known to cause an increase in diacylglycerol level in various tissues. We examine whether protein kinase C (PKC) isoform content in platelets from diabetic patients is increased compared with healthy subjects, as previously described in the retina, aorta, and heart of diabetic rats. Platelet PKC α , β and ζ immunoreactivity in cytosol, membrane and cytoskeleton (CS) fractions were analyzed by immunoblotting in 20 type 2 diabetic patients (who had been treated with diet alone, sulphonylureas or insulin, and whose condition was complicated with retinopathy, nephropathy, neuropathy and/or macroangiopathy) and in five healthy subjects. PKC α , β and ζ immunoreactivity in cytosol, membrane and CS fractions in platelets from diabetic subjects were not significantly higher than those from healthy subjects. However, platelet PKC β immunoreactivity in cytosol fraction was significantly higher in diabetic patients with normal serum creatinine (Cr) level than in diabetic patients with abnormal Cr level (Cr S 1.5 mg/dl) or in healthy subjects. Moreover, significant negative correlation between PKC β immunoreactivity in cytosol fraction of platelets and serum Cr level was found in diabetic patients ( P < 0.05). To clarify the effect of treatment for diabetes, PKC isoform immunoreactivity in platelets was measured in type 2 diabetic patients treated with diet alone, sulphonylurea or insulin treatment. Serum creatinine level in diabetic patients with insulin treatment was significantly higher than in diabetic patients with sulphonylurea treatment and diet alone. In addition, PKC β immunoreactivity in diabetic patients with insulin treatment was significantly suppressed compared with that in patients treated by sulphonylurea treatment. These results suggest that chronic hyperglycemia may activate platelet PKC β isoform, and that insulin treatment may decrease platelet PKCβactivity. Finally, not only PKC β antagonists, but also glycemic control by insulin may prevent development of diabetic microangiopathy.     

Sorbitol intolerance in adults. Prevalence and pathogenesis on two continents

The prevalence and pathogenesis of sorbitol intolerance in adults have not been adequately studied. On oral administration of sorbitol (10 g), 32% of the 124 healthy adults (41 in the U.S.A., 83 in India) developed abdominal symptoms. The orocecal transit time, measured in Asian Indian volunteers by breath hydrogen (H2) analysis, was significantly shorter in those intolerant to sorbitol (71.8 +/- 36.9 min) than in those who were tolerant (109.5 +/- 47.8 min). Our results indicate that sorbitol intolerance is a potential clinical problem in a substantial number of healthy adults. A short orocecal transit time may be responsible for sorbitol intolerance in some people. We discuss the sorbitol content of common foodstuffs.     

Urinary pyridinoline and deoxypyridinoline excretion in children

OBJECTIVE There are few data on urinary markers of collagen breakdown In children. We have determined a normal range for urinary pyridinoline and deoxypyridinoline In children, assessed the variability in excretion in individual children and examined the effect of GH treatment on the excretion of these collagen cross-links. DESIGN A cross-sectional study of a group of healthy children and sequential samples from children receiving GH treatment. PATIENTS One hundred and nine healthy children aged 2–15 years, 8 healthy children aged 4–11 years and 4 children receiving GH treatment. MEASUREMENTS Total pyridinoline and deoxypyridinoline excretion were measured by high performance liquid chromatography after initial acid hydrolysis and cellulose extraction steps. Serum parathyroid hormone was measured using a two-site immunoradiometric assay and urinary hydroxyproline by Ehrlich's reaction using a colorlmetric assay. Pyridinoline and deoxypyridinoline excretion were expressed as a ratio against urine creatinine. RESULTS High excretion of pyridinoline (Pyr) and deoxypyridinoline (DPyr) was seen at all ages with no apparent relation to age (mean Pyr/Cr 115 nmol/mmol and DPyr/Cr 31 nmol/mmol). No correlation was found with serum parathyroid hormone or urinary hydroxyproline excretion. Marked day to day variation was seen in individual children. A progressive rise in excretion was seen In children receiving GH treatment with no significant correlation to height velocity. CONCLUSIONS There is a high excretion of the pyrldi-nium cross-linking amino acids in children of all ages compared to adults. However, a high variability exists In single morning urine samples which will limit the usefulness of these markers in growing children.