骨质疏松症与骨性关节炎的相关性

骨质疏松症和骨性关节炎是骨骼肌肉常见的2种疾病,均具有较高的致残率与致死率.这2种疾病均好发于中老年人,尤其是绝经后妇女.发病率与年龄呈正相关.目前国内外医学界对它们之间的关系持不同的观点.本文从流行病学、发病机制和治疗的角度对两者的关系进行探讨.     

绝经后女性慢性肾脏病患者合并心力衰竭的相关研究进展

绝经后女性由于雌激素水平下降,心血管疾病的风险升高。慢性肾脏病(CKD)是随年龄增长发病率逐年上升的疾病之一,同样多见于绝经后的女性。若绝经后女性同时合并CKD将易出现心力衰竭(HF)。本文将从近年来临床及基础研究结果入手,深入分析绝经后女性CKD患者发生HF的相关机制,以期增进对绝经后女性CKD患者相关研究的了解,促进未来对该病新治疗靶点的识别与进一步研究。     

绝经后女性阴道微生态变化及研究进展

绝经后女性由于雌孕激素水平下降,发生外阴和阴道萎缩、乳酸杆菌比例降低、阴道内菌群失调、阴道免疫屏障受损等病理、生理改变,从而导致一系列的症状、体征和疾病,对绝经后女性的健康及生活质量产生显著的不良影响.现从阴道菌群种类、数量、比例等方面阐述绝经后阴道微生态菌群的变化特征及相关机制,明确全身及局部雌激素治疗对绝经后女性阴道微生态及泌尿生殖道症状改善的作用机制,以便深入了解绝经后女性的阴道微生态变化与泌尿生殖道症状的关系,从而提高绝经后女性的生活质量.     

白细胞介素1与绝经后骨质疏松症相关性研究进展

绝经后骨质疏松症(PMOP)是一种绝经后妇女发病率日趋上升的全身骨性疾病,探讨其发病机制,并针对其机制找到能够预防甚至治疗PMOP的方法,是全球公共卫生亟待解决的重要问题。近年来研究发现,白细胞介素1(IL-1)在PMOP发生发展过程中有明显的作用。该文将通过对IL-1与PMOP的相关性研究进展进行总结,以期为PMOP防治及相关分子机制研究提供理论依据。     

绝经后女性骨密度与中心脉压关系的探讨

<正>骨质疏松症是一种全身性的骨骼疾病,随着年龄的增大而日渐严重,特别在绝经后女性人群中,这种骨代谢异常表现得尤为显著。近年来,人们注意到伴随着钙代谢异常的骨质疏松症常伴有动脉血管钙化和硬化[1,2],提示两者之间可能存在着共同的发病机制。本文通过对155例绝经后女性骨密度和有创中心动脉压测定,旨在探讨绝经后女性人群骨密度降低与动脉硬化之间的关系,为这两种绝经后女性人群常见疾病的综合防治寻找科学的理论依据。     

绝经后骨质疏松症发病的骨免疫学机制

绝经后骨质疏松症与免疫关系密切,可被认为是一种炎症性疾病.本文就免疫学机制参与绝经后骨质疏松症的发病作一综述.     

绝经后女性代谢综合征与冠心病相关机制的研究进展

绝经后代谢综合征与冠心病发病率较绝经前均明显增加,可能与绝经致性激素水平变化,继而引起血压、血脂、糖代谢异常有关。现分析绝经后女性代谢综合征与冠心病的相关机制。     

慢性病毒性肝炎相关血小板减少症研究进展

血小板减少为公认的与感染相关的疾病。许多研究表明血小板减少与慢性肝炎病毒感染相关。慢性病毒性肝炎相关血小板减少症具有多重发病机制。本文目的在于评估该病的流行病学特征、探究其发病机制、总结相关文献提出的治疗方法。     

染色质结构与肾脏疾病遗传风险解析

全基因组关联分析(GWAS)已发现大量与肾脏疾病发病风险相关的遗传变异位点,然而解析这些变异位点的作用机制仍面临重大挑战。随着表观遗传学研究的不断发展,针对染色质结构的相关研究对解析肾脏疾病发病风险做出了重要贡献。本文就目前染色质一维与三维结构在阐述肾脏疾病发病风险与发生机制中的应用做一综述。     

雌激素影响绝经后骨质疏松分子机制研究进展

<正>骨质疏松是以骨量减少、骨的微观结构退化为特征的,致使骨的脆性增加以及易于发生骨折的一种全身性骨骼疾病,可分为三大类即原发性骨质疏松、继发性骨质疏松、特发性骨质疏松。绝经后骨质疏松(PMOP)为Ⅰ型原发性骨质疏松,由绝经后机体雌激素水平下降而引发,年龄通常界定在50~70岁。雌激素的缺乏被认为是PMOP的主要原因,其中具体的分子机制仍未达成共识,本文结合近些年研究雌激素对PMOP发病机     

Circulating oxidized lipoproteins and cardiovascular risk

It has been widely recognized that oxidized low-density lipoprotein (oxLDL) is involved in cardiovascular diseases. However, one of the major questions has been whether oxLDL is a cause or a result of atherosclerotic lesion development. Immunologic detection of human circulating oxLDL has been established, and evidence of a close relationship between oxLDL levels in human circulating plasma and cardiovascular diseases has been accumulating. Recent prospective studies suggest that plasma oxLDL measurement is potentially a predictive marker for cardiovascular diseases. Another question has been how LDL is oxidized in vivo. Recent progress in structural studies has shown evidence that oxLDL in vivo is oxidized differently from copper-induced oxLDL.     

Ig-Therasorb Immunoadsorption for Selective Removal of Human Immunoglobulins in Diseases Associated with Pathogenic Antibodies of All Classes and IgG Subclasses,Immune Complexes,and Fragments of Immunoglobulins

Abstract: Therasorb immunoadsorption (IA), by selectively eliminating pathogenic substances from the circulation, allows for successful therapy of previously insufficiently treatable diseases. Molecules (specific polyclonal sheep antibodies) coupled to a matrix (Sepharose CL 4B) selectively bind plasma components in extracorporeal circulation. This procedure has been established in the treatment of various diseases. Examples are familial hypercholesterolemia (LDL-Therasorb) and selected autoimmune diseases (Ig-Therasorb). Ig-Therasorb IA has been performed in a variety of clinical indications, primarily in the treatment of autoimmune diseases. In most cases, Ig-Therasorb IA has been applied in patients who have failed to respond to conventional therapy with a high rate of clinical improvement. In defined groups of patients with autoimmune diseases and alloantibodies, immunoadsorption can now be considered an established therapeutic means. The fast and efficient removal of immunoglobulins obviously exceeds the efficiency of conventional plasma exchange by far. Autoimmune diseases could be induced by balanced and nonbalanced immunity. The importance of autoantibodies remains unclear, but the efficacy of Ig-Therasorb IA suggests a key role for them. In addition to the established indications for removal of immunoglobulins, there may be a number of promising new indications.     

Immunoadsorption in Dermatology

Immunoadsorption (IA) has been successfully used in a large variety of autoantibody‐mediated disorders. In dermatology, IA is increasingly applied as adjuvant treatment for severe and/or refractory autoimmune bullous diseases. These disorders are characterized by autoantibodies against structural proteins of the skin and/or mucous membranes and include, among others, pemphigus vulgaris, pemphigus foliaceus, and bullous pemphigoid. Autoimmune blistering diseases are associated with a high mortality (pemphigus) or morbidity (bullous pemphigoid) and in particular in pemphigus diseases, treatment is challenging. The pathogenetic role of autoantibodies in most of the immunobullous diseases has been clearly demonstrated, therefore, removal of these autoantibodies is a rational therapeutic approach. IA has been shown to effectively lower the serum autoantibodies and to lead to rapid clinical responses. Most recently, IA has been successfully applied in patients with severe atopic dermatitis and high total serum IgE levels. Here, the different treatment protocols, clinical efficacy, and adverse events are summarized.     

Thymalfasin: an immune system enhancer for the treatment of liver disease

Thymalfasin (thymosin-alpha 1) is an immunomodulating agent able to enhance the Thl immune response. It has been evaluated for its immunomodulatory activities and related therapeutic potential in several diseases, including chronic hepatitis B and C, AIDS, primary immunodeficiency diseases, depressed response to vaccination and cancer. The basis for effectiveness in these conditions is primarily through modulation of immunological responsiveness, as thymalfasin has been shown to have beneficial effects on numerous immune system parameters and to increase T-cell differentiation and maturation. Thymalfasin is responsible for reconstitution of immune function when thymic tissue is given back to thymectomized animals. In addition, thymalfasin has been shown to have efficacy in multiple experimental models of immune dysfunction, mainly, infectious diseases such as hepatitis (woodchuck) and influenza (mouse), and cancer such as melanoma (mouse) and colorectal carcinoma (rat) where thymalfasin has shown antitumor effects.     

Cell type specific infection of Epstein-Barr virus (EBV) in EBV-associated hemophagocytic lymphohistiocytosis and chronic active EBV infection

While Epstein-Barr virus (EBV) tropism in B cells and nasopharygeal epithelial cells in the normal host has been demonstrated, recently the role of its infection into non-B cell populations has been suggested to play a pivotal role in the pathogenesis of several EBV-related hematological as well as non-hematological diseases. Ectopic EBV infection in T cells or natural killer (NK) cells has been reported in EBV-associated hematological diseases, such as acute fulminant EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH) and chronic active EBV infection (CAEBV). Recent advances in the analysis of EBV infection in lymphocyte subpopulations have clarified the differential virus-cell interaction within these EBV-related disorders. EBV infection was predominantly found in CD8(+) T-cells from EBV-HLH, and in CD4(+) T-cells or NK cells from CAEBV, while the majority of EBV infected cells were found in B cells from acute infectious mononucleosis (IM). Different virus-cell interactions between acute EBV-HLH and CAEBV have indicated different pathogenic mechanisms against EBV infection between the two EBV-associated diseases, accounting for the difference in clinical manifestations between the two diseases.     

Therapeutic Plasma Exchange for the Treatment of Rapidly Progressive Glomerulonephritis

Abstract: Therapeutic plasma exchange (TPE) has been widely accepted as a successful means of removing the antiglomerular basement membrane (anti-GBM) antibodies that result in the rapidly progressive glomerulonephritis (RPGN) of Goodpasture's syndrome. TPE has also been investigated as a means of removing the immune complexes associated with the glomerulonephritides of systemic lupus erythematosus, IgA nephropathy, Henoch Schönlein purpura, and cryoglobulinemia. Recently, an antineutrophil cytoplasmic antibody (ANCA) has been implicated in the pathogenesis of RPGN associated with such diseases such as Wegener's granulomatosis and periarteritis nodosa. ANCA has also been found in many cases of RPGN formally considered to be idiopathic. The identification of this autoantibody has given new credence to the possibility that TPE may be beneficial in the treatment of these diseases. This article reviews the data regarding the use of TPE for RPGN.     

Immusorba TR and Immusorba PH: Basics of Design and Features of Functions

Abstract: Immusorba was reported by Yamazaki et al. to be the world's first practical immunoadsorbent in 1982. Since then, this immunoadsorbent has accumulated an abundance of clinical achievements. Immusorba has such unique functions that it is used in treating various diseases and holds possibilities for application to more diseases. Immusorba was designed as an artificial receptor for rheumatoid factor (RF) based on structural analysis of heat-denaturated globulin. Subsequently, new substances that it can adsorb have been found as seen in reports on the adsorption performance of Immusorba to anti-acetylcholine receptor antibodies (anti-AChR Abs) and antiganglioside antibodies. Along with this, Immusorba has been used in treating a wide range of diseases. The greatest characteristic of Immusorba is that its adsorption capability is selective rather than specific, making it effective against a great number of diseases.     

Is angiotensin I-converting enzyme a "master" disease gene?

Clustering of diseases has been appreciated by health insurers and epidemiologists for some time. Co-morbidity suggests shared pathways of disease. It is by now well agreed that common diseases have a strong genetic component. Here we present evidence that the angiotensin I-converting enzyme (ACE) deletion/deletion (D/D) genotype is associated with a large number of common adult diseases, including cardiovascular disease, cancer, and psychiatric disease. Since the ACE D/D genotype has been shown to be associated with increased levels of tissue ACE expression at the protein level, these data suggest that overactivity of ACE may be involved in the pathogenesis of common diseases, as well as the utility of effective ACE inhibition in their treatment and, perhaps, prevention.     

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血压晨峰在近年来的高血压研究中受到越来越多的关注,多项研究证实血压晨峰与心脑血管病的发病及预后密切相关。现本文就血压晨峰的定义、临床意义及治疗策略做一简要综述。     

Biologicals

Over the last years the therapeutic use of biologicals in the treatment of autoimmune diseases and disorders of the complement system has been introduced into clinical practice. Most experience has been gained with the use of the anti-CD20 antibody rituximab. The efficacy of rituximab in the treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated diseases has been shown in randomized trials. Rituximab is also effective in the treatment of membranous glomerulonephritis, cryoglobulinemia and treatment-resistant lupus nephritis but the available data are insufficient for general recommendations with high evidence. The role of rituximab in the treatment of other kidney diseases (e.g. focal segmental glomerulosclerosis FSGS) is unclear. For belimumab, which is approved for the treatment of systemic lupus erythematosus (SLE), no recommendations for the use in lupus nephritis can be given due to the lack of studies. Eculizumab is approved for the treatment of atypical hemolytic-uremic syndrome (aHUS); however, currently there are uncertainties about the indications and therapeutic strategies in the treatment of aHUS and complement-associated forms of membranoproliferative glomerulonephritis (MPGN). New randomized studies are needed to clarify the role of biologicals in the treatment of immunological renal diseases.