老年不稳定型心绞痛患者外周血内脏脂肪素水平的改变及意义

目的观察内脏脂肪素在老年不稳定型心绞痛(UA)外周血水平的变化,探讨其与炎症因子及相关黏附分子之间的相关性。方法比较UA患者44例(观察组)及稳定型心绞痛(SA)42例(对照组)两组血脂指标、内脏脂肪素、炎症性因子、可溶性血管细胞间黏附分子(sVCAM)-1、可溶性细胞间黏附分子(sICAM)-1水平;并采用Pearson相关检验对内脏脂肪素与肿瘤坏死因子(TNF)-α、sVCAM-1、sICAM-1进行相关性分析。结果两组血脂指标总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、白细胞介素(IL)-10水平无显著差异(均P>0.05);观察组内脏脂肪素、VCAM-1、sICAM-1、TNF-α水平显著高于对照组(P<0.05);相关性分析显示UA患者内脏脂肪素水平与TNF-α(r=0.693,P<0.01)、sVCAM-1(r=0.722,P<0.01)及sICAM-1(r=0.708,P<0.01)呈正相关。结论 UA患者体内内脏脂肪素水平比SA患者高,并且与TNF-α、VCAM-1、sICAM-1呈正相关,说明内脏脂肪素与血管内皮损伤有关,可作为预测不稳定斑块的指标。     

冠心病患者炎性标志物的检测水平及意义

目的:探讨血清肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)和可溶性细胞间黏附分子-1(sICAM-1)在冠心病(CHD)发病机制中的意义。方法:采用酶联免疫吸附法(ELISA),检测86例CHD患者TNF-α、IL-8和sICAM-1水平,并与30例正常对照者进行比较。结果:CHD患者TNF-α、IL-8和sICAM-1水平显著高于正常对照组(P<0.01),急性心肌梗死患者和不稳定型心绞痛患者TNF-α、IL-8和sICAM-1水平显著高于稳定型心绞痛患者(P<0.01)。结论:TNF-α、IL-8和sICAM-1可能参与了CHD的发病过程,且与病变稳定性有关。     

活动性幼年特发性关节炎患者sICAM-1 sVCAM-1的表达及意义

目的测定各型活动性幼年特发性关节炎(JIA)患儿血清中可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管间黏附分子-1(sVCAM-1)、白细胞介素(IL)-1、IL-4、肿瘤坏死因子(TNF)-α水平,探讨sICAM-1、sVCAM-1与疾病活动、疾病分型以及疾病严重程度的关系。方法用酶联免疫吸附试验(ELISA)检测30例活动性JIA患儿与8名健康对照儿童sICAM-1、sVCAM-1水平;用放射免疫法(RIA)检测IL-1、IL-4、TNF-α水平。结果30例JIA患者血清中sICAM-1、sVCAM-1、IL-1、IL-4、TNF-α水平明显高于健康对照组(P<0.01);在各型JIA中sVCAM-1与血沉(ESR)、C反应蛋白(CRP)呈正相关(P<0.05或0.01);而sICAM-1仅在全身型及多关节型JIA患儿中与关节肿胀指数、夜间痛呈正相关(P<0.01),与炎性指标ESR、CRP等无关。结论JIA患者血清中sICAM-1、sVCAM-1、IL-1、IL-4、TNF-α水平显著升高,可能参与了JIA的发病过程,sVCAM-1、sICAM-1可与ESR、CRP一起作为判断病情严重性的指标,且可能与JIA分型有关。     

氟伐他汀对充血性心力衰竭患者血清sICAM-1和sVCAM-1的影响

目的:探讨氟伐他汀短期治疗对充血性心力衰竭(CHF)患者血清中可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)和肿瘤坏死因子α(TNF-α)水平的影响。方法:将97例CHF患者随机分为对照组(常规治疗组)和试药组(氟伐他汀组)。采用ELISA测定治疗前及治疗两周后血清中sICAM-1、sVCAM-1和TNF-α水平。结果:两种方法都可以明显降低血清sICAM-1、sVCAM-1和TNF-α水平(P0.05);试药组血清TNF-α水平降低更为显著(P0.05),但血清sICAM-1和sVCAM-1降低水平与对照组无显著差别。结论:在常规治疗基础上短期加用氟伐他汀治疗不能进一步降低CHF患者血清sICAM-1和sVCAM-1水平。     

冠心病病人外周血miR-126与sVCAM-1的表达及其相关性研究

目的探讨冠心病病人外周血微小RNA-126(miR-126)与血管间黏附分子-1(sVCAM-1)、相关炎性因子表达及其相关性,分析其在冠心病发生、发展中的可能作用。方法选取住院确诊的冠心病病人80例为研究对象(冠心病组),选取同期门诊健康体检无异常的40名中老年人作为对照(对照组)。以实时荧光PCR检测外周血清miR-126,夹心酶联免疫吸附法检测sVCAM-1,以免疫透射比浊法测定超敏C反应蛋白(hs-CRP),以双抗夹心法测定肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)。结果冠心病组miR-126表达量低于对照组(P0.05),sVCAM-1及相关炎性因子表达水平高于对照组(P0.05)。急性心肌梗死病人miR-126表达量低于不稳定型心绞痛病人和稳定型心绞痛病人(P0.05),sVCAM-1及相关炎性因子表达水平高于稳定型心绞痛病人及不稳定型心绞痛病人(P0.05);不稳定型心绞痛病人miR-126表达量低于稳定型心绞痛(P0.05),sVCAM-1及相关炎性因表达均高于稳定型心绞痛病人(P0.05)。Pearson相关分析显示,冠心病病人血miR-126与sVCAM-1及炎性因子IL-1、IL-6、TNF-α、hs-CRP表达均呈负相关(P0.05)。结论冠心病病人存在明显的miR-126表达下调,sVCAM-1及相关炎性因子表达上调,与病情活动及冠状动脉受累严重程度密切相关,下调的miR-126失去对VCAM-1及相关炎性因子的抑制作用可能是导致冠心病发生及发展的主要机制之一。     

妊娠期糖尿病患者血清sICAM-1、sVCAM-1和TNF-α水平检测及意义

采用ELISA法测定29例妊娠期糖尿病（GDM）患者（GDM组）及30例正常妊娠妇女（对照组）血清可溶性细胞间黏附分子-1（sICAM-1）、血管内皮细胞黏附分子-1（sVCAM-1）和肿瘤坏死因子-α（TNF—d）水平；分析其与血清空腹胰岛素（INS）、血浆葡萄糖浓度（FBG）及胰岛素抵抗的关系。结果GDM组血清TNF-α、sICAM-1、sVCAM-1均明显高于对照组IGDM组血清TNF-α水平与胰岛素敏感指数（ISI）、sICAM-1及sVCAM-1呈正相关（P均〈0．01）,GDM组血清TNF-α与sICAM-1及sVCAM-1存在协同表达作用。认为联合检测血清TNF-α、sICAM-1和sVCAM-1对控制GDM患者妊娠过程中血管内皮细胞的黏附、减少GDM发生有重要意义。     

急性冠状动脉综合征患者血清sICAM-1、sVCAM-1、sP-选择素表达及意义

采用ELISA法测定40例急性冠脉综合征患者（AC组）、30例稳定型心绞痛患者（SAP组）及28例正常人（对照组）血清可溶性细胞间黏附分子-1（sICAM-1）、血管细胞间黏附分子-1（sVCAM-1）、P-选择素（sP-selectin）水平。结果ACS组血清sICAM-1、sVCAM-1、sP-selectin水平显著高于SAP组和对照组（P均〈0.01）,SAP组与对照组无显著性差异（P〉0.05）。ACS组血清sICAM-1、sVCAM-1与sP-selectin呈显著正相关（r=0.516、0.521,P均〈0.05）。提示ACS患者血清sICAM-1、sVCAM-1、sP-selectin水平均明显升高,并共同作用促进ACS的发生、发展。     

可溶性细胞间黏附分子－1与不稳定型心绞痛病人预后的关系

目的探讨不稳定型心绞痛(unstable angina pectoris,UA)病人外周血可溶性细胞间黏附分子(soluble intercellular adhesion molecule-1,sICAM-1)水平及其与预后的关系。方法UA组86例,稳定型心绞痛(stable angina pectoris,SAP)组22例。对照组20名为体检健康者。入院24h内或接受体检时采集血标本。用酶联免疫吸附试验方法测定外周血sICAM-1水平。对比较UA组病人心肌梗死试验性溶栓疗法危险评分与sICAM-1水平关系。随访30d和90d,统计心血管不良事件。结果UA病人外周血sICAM-1水平显著高于SAP病人(P<0.01);UA病人sICAM-1水平随心肌梗死试验性溶栓疗法危险积分的增高而增高;高sICAM-1组的不稳定型心绞痛病人近期心脏不良事件发生率明显升高(P<0.01)。结论外周血sICAM-1水平可反映UA病情危险程度,UA病人近期心血管不良事件与高外周血sICAM-1水平有关。     

原发性胆汁性肝硬化患者血清可溶性血管细胞黏附分子-1和可溶性细胞间黏附分子-1的表达及其临床意义

目的 检测原发性胆汁性肝硬化(PBC)患者血清中可溶性血管细胞黏附分子-1(sVCAM-1)及可溶性细胞间黏附分子-1(sICAM-1)的表达,并探讨其临床意义.方法用酶联免疫吸附法(ELISA)测定27例PBC患者及20例对照组血清sVCAM-1、sICAM-1的含量,分别比较PBC患者child-pugh分级各级别上述因子表达水平.结果 PBC患者血清sVCAM-1和sICAM-1水平明显高于对照组(P<0.05);child-pugh分级B、C级患者血清sVCAM-1和sICAM-1水平高于A级(P<0.05).结论sVCAM-1、sICAM-1参与了PBC的病理生理过程,与疾病分级相关,血清8VCAM-1、sICAM-1含量增高可作为原发性胆汁性肝硬化肝损害的判断指标.     

急性冠脉综合征患者血清炎性标志物浓度变化及其临床意义

目的探讨血清炎性标志物与急性冠脉综合征(ACS)的关系。方法检测48例ACS患者血清C-反应蛋白(CRP)、可溶性血管内皮细胞黏附分子-1(sVCAM-1)和可溶性细胞间黏附分子-1(sICAM-1)等炎性因子变化,与冠脉造影结果和临床预后进行对比分析。结果1ACS组血清CRP与sICAM-1、sVCAM-1水平均高于稳定性心绞痛(SA)组和正常对照组;2sVCAM-1≥870ng/ml者3个月内主要冠脉不良事件(MACE)发生率明显高于<870ng/ml者;3血清肌钙蛋白阳性者CRP、sICAM-1、sVCAM-1浓度均明显高于阴性者;4冠脉狭窄程度在ACS组与SA组无统计学差异;冠脉狭窄程度积分与TC水平呈正相关,而与血清CRP、sICAM-1、sV-CAM-1及血浆纤维蛋白原(Fig)水平均无相关性;5sVCAM-1、Fig和肌钙蛋白预测3个月内MACE发生的敏感性分别为67.5%、82.4%、57.1%;特异性分别为54.8%、58.1%、81.5%。结论血清炎性标志物对ACS患者临床危险分层和判断预后有重要意义。     

Tissue specific and cyclic expression of insulin-like growth factor binding proteins-1,-2,-3,-4,-5,-6 in the rat oviduct

Although much is known about the expression insulin-like growth factors (IGF) and their receptors in the murine oviduct, significantly less is known about the expression of IGF binding proteins (IGFBPs). To fill this gap in our knowledge, we identified and characterized the tissue specific expression of IGFBP-1 to-6 in rat oviducts over the estrous cycle byin situ hybridization and immunocytochemistry. Tissues were analysed on proestrus (P1000 h, P2000 h), estrus (E0200, E1000 h), and diestrus I and II (DI 1100 h, DII 1100 h). IGFBP-1 was undetectable in the oviduct over the cycle. IGFBP-2 was selectively expressed in the luminal epithelium. The mRNA levels were high between P2000 h and E1000 h but low or undetectable thereafter. Immunoreactive IGFBP-2 was strong to very strong in these cells over most of the cycle. IGFBP-3 mRNA was undetectable in the oviduct; however, strong hybridization and immunoreactive signals were present in the mesosalpinx and mesotubarium, particularly at DI and DII. IGFBP-4 mRNA was not detected in the oviduct. In contrast, immunoreactive IGFBP-4 was observed in the luminal epithelium and the intensity was very strong after ovulation (E1000 h, DI and DII). IGFBP-5 and-6 mRNAs were selectively expressed in circular smooth muscle cells. Hybridization signals were evident over the cycle, but were greatest at estrus. By comparison, IGFBP-5 and-6 proteins were essentially undetectable in these cells except at DII 1100 h when immunostaining was moderate to high. Luminal epithelial cells were weakly positive for IGFBP-5 and-6. However, intense immunostaining was associated with the ciliated border and the luminal fluid juxtaposed to these cells during the cycle. The oocyte-cumulus complexes were immunostained intensely for IGFBP-2,-4,-5 and-6, but their mRNAs were undetectable. The signals were strongest in degenerating cumulus cells suggesting a potential role for these IGFBPs in cumulus apoptosis. These results demonstrate that the estrous cycle is accompanied by major changes in the pattern of expression of IGFBP-2,-4,-5 and-6 in the rat oviduct. We therefore conclude that the regulated production of these particular IGFBPs may be functionally important in modulating IGF activities in the oviduct, oocyte cumulus complexes, and perhaps the preimplantation embryo as well.     

ADAMTS-3, -13, -16, and -19 levels in patients with habitual abortion

A disintegrin-like and metalloproteinase domain with thrombospondin-type 1 motifs (ADAMTS) protein superfamily includes 19 secreted metalloproteases. Proteolytic substrates of ADAMTS enzymes have been linked to reproductive function. The aim of this study was to investigate serum ADAMTS-3, -13, -16, and -19 levels in women with habitual abortions compared with those in healthy controls. A total of 86 women were enrolled in this prospective case-control study. ADAMTS-3, -13, -16, and -19 values were recorded and analyzed in association with demographic and clinical parameters. There were no statistically significant differences between the two groups in terms of demographics. No statistically significant differences were observed between the groups with regard to ADAMTS-13 and -19 levels (p > 0.05). However, ADAMTS-3 and -16 were significantly higher in the study group than in the control group (p = 0.004 and p = 0.005, respectively). To estimate habitual abortions using an area under receiver operating characteristic curve analysis, the cutoff values for ADAMTS-3 and -16 were found to be 87.28 ng/mL (sensitivity, 64.44%; specificity 68.29%) and 15.75 ng/mL (sensitivity, 66.67%; specificity 68.29%), respectively. In conclusion, the pregnancy-loss rate seems to be affected by both ADAMTS-3 and -16.     

Disaster hypertension - its characteristics, mechanism, and management -

The devastating Great East Japan Earthquake, which was 9.0 on the Richter scale, occurred on March 11, 2011. Japan experienced the Great Hanshin-Awaji Earthquake 16 years ago, and I was working at the epicenter, and reported the characteristics of the earthquake-associated cardiovascular risk and high blood pressure (BP) found during the continuous practice and clinical studies of Tsuna Medical Association before and after the quake. A major disaster increases thrombophilic tendency and BP, both of which trigger disaster-induced cardiovascular events such as stroke, cardiac events, etc. The high salt intake and the increased salt sensitivity caused by disrupted circadian rhythms are the 2 major leading causes of disaster hypertension (HT) through neurohumoral activation under stressful conditions. To better assess and reduce the risks for disaster-associated cardiovascular events, we introduced the web-based Disaster Cardiovascular Prevention (DCAP) network (which consists of DCAP risk and prevention score assessment, and self-measured BP monitoring at both the shelter and the home) to the survivors of the 2011 disaster, and frequently found newly developed HT. Here I review the recent evidence, possible mechanism and the management of "disaster HT" for effective prevention of disaster-induced cardiovascular events.     

Evaluation of Apaf-1 and procaspases-2, -3, -7, -8, and -9 as potential prognostic markers in acute leukemia

Recent studies have suggested that variations in levels of caspases, a family of intracellular cysteine proteases, can profoundly affect the ability of cells to undergo apoptosis. In this study, immunoblotting was used to examine levels of apoptotic protease activating factor-1 (Apaf-1) and procaspases-2, -3, -7, -8, and -9 in bone marrow samples (at least 80% leukemia) harvested before chemotherapy from adults with newly diagnosed acute myelogenous leukemia (AML, 42 patients) and acute lymphocytic leukemia (ALL, 18 patients). Levels of each of these polypeptides varied over a more than 10-fold range between specimens. In AML samples, expression of procaspase-2 correlated with levels of Apaf-1 (R(s) = 0.52, P <.02), procaspase-3 (R(s) = 0.56, P <.006) and procaspase-8 (R(s) = 0.64, P <.002). In ALL samples, expression of procaspases-7 and -9 was highly correlated (R(s) = 0.90, P <.003). Levels of these polypeptides did not correlate with prognostic factors or response to induction chemotherapy. In further studies, 16 paired samples (13 AML, 3 ALL), the first harvested before induction therapy and the second harvested at the time of leukemia regrowth, were also examined. There were no systematic alterations in levels of Apaf-1 or procaspases at relapse compared with diagnosis. These results indicate that levels of initiator caspases vary widely among different leukemia specimens but cast doubt on the hypothesis that this variation is a major determinant of drug sensitivity for acute leukemia in the clinical setting. (Blood. 2000;96:3922-3931)     

Def-2, -3, -6 and -8, novel mouse genes differentially expressed in the haemopoietic system

To identify developmentally regulated genes during myeloid differentiation, a self-inactivating retroviral gene-trap vector carrying a beta-galactosidase-neomycin (SA/lacZ/neo) fusion gene was constructed and used to infect myeloid progenitor cells (FDCP-Mix A4). G418-resistant and beta-galactosidase positive cell lines (gene-trap integration [GTI] clones) were established and induced to differentiate in vitro into either macrophages or granulocytes. Expression of the trapped loci was monitored at a single-cell level by analysing the mature cell types for beta-galactosidase activity. All 37 GTI clones tested showed down-regulation either during granulocyte or both granulocytic and macrophage differentiation. The endogenous coding regions fused to the SA/lacZ/neo reporter gene were isolated from eight clones. Molecular analysis revealed that half of them represented novel mouse genes (def-2, -3, -6 and -8) which we confirmed to be differentially expressed in primary haemopoietic tissues. Database searches revealed no significant similarities for def-2 (associated with haemopoietic progenitors) and def-8 (expressed most strongly in peripheral leucocytes). Def-6, which is down-regulated upon the differentiation into myeloid as well as erythroid lineages, was found to be closely related but not identical with the recently described B-cell-specific switch recombinase SWAP-70. Def-3, which is down-regulated upon differentiation into granulocytes but expressed in progenitor cells and macrophages, defines a novel family of RNA binding proteins.