糖尿病合并肺结核患者sFas／sFasL与T淋巴细胞的关系

目的观察糖尿病合并肺结核患者外周血sFas／sFasL和T淋巴细胞凋亡及其亚群的变化及在糖尿病合并肺结核发生发展中的作用。方法采用酶联免疫吸附实验（ELISA）检测各组外周血sFas和sFasL含量,用流式细胞仪分析淋巴细胞凋亡百分率。用单克隆抗体碱性磷酸酶标记法（APAAP）检测外周血CD3^＋、CD4^＋和CD8^＋ T淋巴细胞数量。结果肺结核、糖尿病和糖尿病合并肺结核患者外周血sFas、sFasL含量均明显高于正常对照组（P〈0．01）,糖尿病患者外周血sFasL含量明显高于其他组（P〈0．01）。糖尿病合并肺结核患者外周血sFasL含量明显低于糖尿病组（P〈0．01）。糖尿病合并肺结核组患者淋巴细胞凋亡率明显高于正常对照组及肺结核组。肺结核、糖尿病及糖尿病合并肺结核组患者与正常对照组相比较,外周血CD3^＋、CD4^＋T细胞降低。结论糖尿病合并肺结核患者存在细胞免疫功能失调,sFas／sFasL系统和T淋巴细胞在糖尿病合并肺结核的发病机制中起着重要的作用,外周血sFasL含量可作为鉴别糖尿病是否已合并肺结核的指标。     

糖尿病合并肺结核患者的转化生长因子β1与sFas／sFasL的检测

目的检测糖尿病合并肺结核患者外周血转化生长因子β1（TGF-β1）与sFas／sFasL的水平,并探讨两者在糖尿病合并肺结核发生发展中的作用。方法采用酶联免疫吸附实验（ELISA）检测10例正常人、20例肺结核患者、20例2型糖尿病患者和15例糖尿病合并肺结核患者的外周血TGF-β1水平及sFas和sFasL含量。用流式细胞仪分析淋巴细胞凋亡百分率。结果肺结核、糖尿病及糖尿病合并肺结核患者外周TGF-β1及sFas、sFasL含量均明显高于正常对照组（P〈0．01）,糖尿病合并肺结核患者TGF-β1含量明显高于肺结核和糖尿病患者（P〈0．01）。糖尿病患者外固血sFasL含量最高。糖尿病合并肺结核组患者淋巴细胞凋亡率明显高于正常对照组及肺结核组（P〈0．01）。结论糖尿病合并肺结核后TGF—β1和sFas／sFasL水平明显升高,可能与患者的细胞免疫功能失调有关,两者在糖尿病合并肺结核的发病机制中发挥着重要作用,另外外周血sFasL含量可作为鉴别糖尿病是否已合并肺结核的指标。     

糖代谢异常对急性心肌梗死患者血清炎性细胞因子TNF-α和IL-6的影响

目的 了解糖代谢异常对急性心肌梗死患者血清炎性细胞因子TNF-α和IL-6的影响.方法 急性心肌梗死患者根据OGTF检测结果将其分为糖耐量正常(NGT)、糖耐量异常(IGT)和糖尿病(DM)三组.应用ELISA方法测定三组患者血清TNF-α和IL-6的含量.结果 AMI合并DM患者血清TNF-α和IL-6的浓度高于NGT和IGT患者,P<0.05.心功能killip3～4级患者血清TNF-α和IL-6的浓度也高于killip1～2级患者,P<0.05.结论 糖尿病加剧了急性心肌梗死时的炎症反应.     

急性心肌梗死患者血清Hcy、sFas和sFasL的水平及相关分析

目的探讨急性心肌梗死患者血清Hcy水平的变化和可溶性Fas(sFas)及可溶性Fas配体(sFasL)水平的相关性。方法应用酶联免疫吸附法对42例急性心肌梗死患者进行了血清Hcy和血清sFas、sFasL检测并与40例正常健康人做比较。结果急性心肌梗死患者血清Hcy与sFas、sFasL水平非常显著地高于正常对照组(P<0.01),血清Hcy水平与sFas、sFasL水平互呈明显正相关(P<0.01)。结论急性心肌梗死患者血清Hcy与sFas、sFasL水平密切相关。     

高血压所致慢性充血性心力衰竭患者血清sFas水平及临床意义

目的：观察高血压所致慢性充血性心力衰竭（CHF）患者血清sFas浓度的变化并探讨其临床意义。方法：选取高血压所致慢性充血性心力衰竭患者22例,单纯高血压患者19例,正常对照组21例。采用ELISA法测定血清sFas浓度。结果：①与正常对照组相比,高血压CHF组血清sFas水平显著升高（P〈0．01）,高血压无CHF组和对照组之间血清sFas的水平变化无统计学意义（P〉0．05）。②sFas水平随心功能不全的加重而明显升高,心功能Ⅳ级组患者高于心功能Ⅱ、Ⅲ级组患者（P〈0．05）。结论：由高血压所致慢性充血性心力衰竭患者血清凋亡相关因子sFas水平明显升高,细胞凋亡在此类心衰的发病机制中起了重要作用。     

急性心肌梗死患者细胞凋亡水平影响因素的分析

目的探讨急性心肌梗死（AMI）时可能影响细胞凋亡水平的因素。方法73例AMI患者分别根据发病到八院的时间、患者年龄、病变部位和冠状动脉病变支数进行分组，检测血清细胞凋亡信号分子sFas水平。结果不同的缺血时间组之间血清sFas浓度差异具有显著性（P〈0．05），而不同年龄组、不同冠状动脉病变程度组、不同心肌梗死部位组之间血清sFas浓度差异无显著性（P〉0．05）。结论细胞凋亡水平随缺血时间的延长而增加，提示我们在AMI治疗中应及时而有效地恢复心肌细胞的血液供应，从而改善AMI患者的预后。     

大肠癌围手术期血清sFas／sFasL水平检测的临床意义

目的探讨大肠癌患者围手术期sFas／sFasL的变化及其临床意义。方法采用双抗体夹心酶联免疫法（ELISA）测定56例大肠癌患者手术前后血清sFas／sFasL的变化，并与健康对照组比较分析。结果大肠癌组治疗前sFas／sFasL均增高，与对照组比较有显著性差异（P〈0．01）；且与淋巴结转移和肿瘤临床Dukes分期有明显相关性（P〈0．05）。行根治性手术组术后sFas／sFasL均有显著性降低（P〈0．05），而姑息性手术组sFas／sFasL则无显著性降低（P〉0．05）。结论大肠癌患者血清sFas／sFasL的水平与肿瘤的浸润转移和病程有关，检测大肠癌患者血清sFas／sFasL的变化，有助于估计患者的预后。     

急性心肌梗死患者血清可溶性Fas和Hcy的水平及相关分析

目的：探讨急性心肌梗死患者血清可溶性Fas（sFas）水平的变化和Hcy水平的相关性。方法：应用酶联免疫吸附法对42例急性心梗患者进行了血清sFas和血清Hcy检测并与40例正常健康人做比较。结果：急性心肌梗死患者血清sFas与Hcy水平非常显著地高于正常对照组（P〈0.01）,血清sFas水平与Hcy水平呈明显正相关（r=0.586,P〈0.01）。结论：急性心肌梗死患者血清sFas与Hcy水平密切相关。     

可溶性Fas检测在冠心病诊疗中的临床价值

目的：探讨冠心病患者血清可溶性Fas（sFas）水平变化的临床意义。方法：应用酶联免疫吸附法（ELISA）对入选的90例冠心病患者（急性心肌梗死患者28例,不稳定型心绞痛患者35例,稳定型心绞痛患者27例）的外周血sFas水平进行检测,并与30例正常对照者血清sFas的浓度进行比较。结果：急性心肌梗死组和不稳定型心绞痛组血清sFas水平明显高于稳定型心绞痛组和正常对照组（P〈0.05）,随访期各组心血管事件发生率与各组sFas水平的梯度差异一致。结论：sFas的升高在冠心病的发生发展中起重要作用,是反映斑块不稳定的指标之一,其水平变化对了解病情,观察预后有重要的临床价值。     

老年糖尿病合并急性心肌梗死的临床特点分析

目的：探究分析老年糖尿病合并急性心肌梗死的临床特点。方法将30例老年糖尿病合并急性心肌梗死患者（A组）与30例非老年糖尿病合并急性心肌梗死患者（B组）作为临床研究对象,对两组患者的临床特点以及恶化死亡率进行观察对比。结果 A组患者的心律失常、无胸痛、急性左心衰竭、心源性休克、肺部感染以及出汗等临床症状发生率显著高于B组（P〈0.05）;A组患者的恶化死亡率明显高于B组（P〈0.05）。结论老年糖尿病合并急性心肌梗死患者病情较重,临床并发症发生率和恶化死亡率较高,对其进行治疗时,要尽早进行诊断,并采用针对性的治疗方法,降低病死率。     

Serum levels of sFas and sFasL in subjects with type 2 diabetes — the impact of arterial hypertension

Aim

To evaluate the serum levels of sFas and sFasL in normotensive subjects with different degree of impairment of glucose tolerance as well as in type 2 diabetic patients with treated and treatment-naïve hypertension (AHT).

Material and methods

124 subjects (63 males and 61 females), of mean age 46,31±10,78 years are included in the study, divided in 5 age-matched groups: 19 subjects with type 2 diabetes (DM) and drug-controlled AHT; 30 subjects with type 2 DM and drug-naïve AHT; 30 normotensive subjects with type 2 DM; 26 normotensive subjects with prediabetes and 19 healthy controls. Serum sFas and sFasL levels are determined by highly sensitive enzyme immunoassay technique.

Results

No significant differences in sFas are observed among the studied groups. The levels of sFasL are decreased in normotensive subjects with type 2 DM (p<0,05), while subjects with prediabetes have intermediate values. In both hypertensive groups with DM sFasL levels are further decreased.

Conclusions

Serum sFas levels probably are not associated with the presence of impairment of glucose tolerance or AHT. Serum sFasL values tend to be decreased in subjects with impairment in glucose tolerance; further decrease is observed in hypertensive subjects with type 2 DM. Antihypertensive treatment does not influence the levels of sFasL.     

Apoptosis of blood mononuclear cells in alcoholic liver cirrhosis. The influence of in vitro ethanol treatment and zinc supplementation

Ethanol consumption induces apoptosis in a variety of tissues, among others in liver and lymphoid tissue. Zinc has been shown to influence apoptosis of blood mononuclear cells by inhibiting the mitochondrial pathway of cell death. The aim of this study was to examine the influence of zinc on spontaneous and in vitro alcohol-induced apoptosis of peripheral blood mononuclear cells (PBMCs) of patients with alcoholic cirrhosis. PBMCs were isolated from the blood of 26 patients with cirrhosis and 20 healthy controls. PBMCs and among them CD4+ T helper cells of cirrhotic patients exhibited accelerated spontaneous (without treatment) apoptosis in vitro. When apoptosis was induced in vitro by treating cells with 80 mM ethanol, CD8+ T lymphocytes of a healthy control were more sensitive to ethanol treatment than those of cirrhotic patients. Thirty micromolar zinc supplementation inhibited both spontaneous and ethanol-induced apoptosis of immune cells derived from the blood of the healthy control and cirrhotic patients. In sera of patients with cirrhosis, an elevated level of IL-12, but also sFas (CD95) and sFas ligand (sFasL) was detected. Moreover, in vitro, PBMCs of cirrhotic patients spontaneously released more sFas and sFasL than control PBMCs. Ethanol treatment significantly increased sFas, but decreased sFasL release from PBMCs of cirrhotic patients, while it only slightly affected control cells. As zinc supplementation did not significantly influence sFas or sFasL release, it seems likely that it is rather the mitochondrial pathway of ethanol-related immune cell death that may be inhibited by zinc supplementation.     

联检慢性心力衰竭患者血清sCD40L、可溶性Fas和sFasL的临床意义

目的 探讨慢性心力衰竭患者治疗前后血清可溶性CD40L(sCD40L)、sFas和sFasL水平的变化及意义.方法 应用放免法对40例慢性心力衰竭患者进行了治疗前后血清sCD40L、sFas和sFasL的检测,并与40例正常健康人作比较.结果 在慢性心力衰竭治疗前,患者血清sCD40L、sFas和sFasL水平非常显著地高于正常人组(P＜0.01),治疗后2周,则与正常健康人组比较差异无统计学意义(P＜0.05).结论 检测慢性心力衰竭患者血清sCD40L、sFas和sFasL水平的变化对了解病情、观察预后均有重要的临床价值.     

急性ST段抬高心肌梗死合并糖代谢异常患者的临床特征和预后分析

目的 了解急性ST段抬高心肌梗死合并糖代谢异常患者的临床特征和预后情况.方法 选择2010年1月～2011年10月在我院住院的235例急性ST段抬高心肌梗死患者为研究对象,无明确糖尿病史的患者在出院前常规行口服葡萄糖耐量试验(OGTT),根据糖代谢状况分为糖代谢正常(NGT)组、糖调节受损(IGR)组和糖尿病(DM)组,收集所有患者的生化指标、心脏彩超及冠脉造影等资料,比较上述指标在不同糖代谢患者之间的差异.同时对上述患者进行随访,观察心绞痛、再发心肌梗死、心衰和心源性死亡的发生情况.结果 急性心肌梗死合并糖尿病患者中女性较多,入院时心率、血糖、糖化血红蛋白、甘油三酯较高,梗死面积较大,心功能较差,冠脉三支病变比例较高,预后较差.糖调节受损患者甘油三酯水平和心力衰竭发生率也高于糖代谢正常心肌梗死患者,而其他指标两者之间无明显差异.结论 急性心肌梗死合并糖代谢异常患者病情较重,预后较差.     

Dysregulation of apoptosis in scorpion envenomed children: its reflection on their outcome.

In the present study, 46 children in Upper Egypt (less than 13 years old) were admitted to the Pediatric Intensive Care Unit for scorpion envenomation. They were compared with 20 apparently healthy children of matching age and sex as controls. Out of the studied victims, 25 children (54%) showed signs of severe envenomation and multiple organ dysfunction (MOD), while 21 victims (46%) showed signs of mild envenomation. The serum levels of apoptotic markers, soluble Fas (sFas), soluble Fas ligand (sFasL) and Bcl-2, were determined for both victims and controls. In addition, the serum levels of nitric oxide (NO) and lipid peroxides (LPO) were also measured. Scoring of MOD was evaluated using Logistic Organ Dysfunction System Score (LODS) for the severely envenomed victims. All victims (both severe and mild cases) showed significantly higher mean levels of sFas, LPO and NO and significantly lower serum levels of Bcl-2 in comparison to the controls. The level of sFasL was not detectable in the sera of the healthy control group. The case fatality rate was 15%. The severely envenomed children with MOD as well as the non-survivors showed significantly higher serum levels of sFas, sFasL, LPO and NO and significantly lower serum levels of Bcl-2 in comparison to the mild envenomed victims and the surviving victims of severe cases, respectively. The LODS score of the severely envenomed victims showed significant positive correlations with sFas and LPO and significant negative correlation with Bcl-2. In all victims, a significant positive correlation was detected between sFas and NO. On the other hand, Bcl-2 was significantly negatively correlated with both sFas and LPO. In conclusion, our study revealed that scorpion envenomation can increase apoptosis as shown by up-regulation of sFas/sFasL system and down-regulation of Bcl-2 that was associated by elevation of LPO and NO. This dysregulation of apoptosis was increased with the severity of scorpion envenomation and its extent increased as MOD score and outcome increased. Therefore, sFas and Bcl-2 may be of value in predicting the outcome of these cases. The increase of the extent of apoptosis detected in this study seems to play a role in the outcome of scorpion envenomation, and hence, should be taken into consideration for strategies of therapeutic regimen.     

急性心肌梗死患者糖代谢状况分析

目的探讨急性心肌梗死患者的糖代谢状况。方法连续选择自2010年10月～2011年9月在我院住院的235例急性心肌梗死患者为研究对象,无明确糖尿病史的患者在出院前均常规行口服葡萄糖耐量(OGTT)试验,以明确糖代谢状况。结果急性心肌梗死患者中糖尿病患病率为44.7%,糖调节受损患病率为25.1%,总的糖代谢异常患病率为69.8%。除去既往有糖尿病史的患者,新诊断的糖尿病和糖调节受损患病率分别为24.9%和34.1%。结论急性心肌梗死患者中大多数存在糖代谢异常,行OGTT可及早发现糖代谢异常患者。     

Vascular complications of diabetes mellitus

1. Macro- and microvascular diseases are the main chronic complications of diabetes mellitus (DM). 2. It has been shown that DM patients have more severe nailfold microcirculatory disturbances than patients with liver cirrhosis or systemic lupus erythematosus (SLE). 3. It has been shown that the glomerular basement membrane of diabetic rats is significantly thickened compared with that of normal rats (295.5 +/- 45.1 vs 184.8 +/- 33.2 nm). 4. Gastric mucosal blood flow (GMBF) in 41 patients with non-insulin-dependent diabetes mellitus (NIDDM) was determined with a laser Doppler flowmeter. The results showed that average GMBF values at 14 sites in the gastric mucosa were significantly lower in NIDDM patients than in control subjects. 5. The percentage of painless acute myocardial infarction (AMI) among 50 patients with DM was 22.0% and the mortality of AMI was 22.0% (11 cases). Both these values were higher than the corresponding values in patients without DM (9.9 and 11.4%, respectively; P < 0.05). 6. Cerebrovascular disease is more prevalent in diabetic patients than in non-diabetics and the mortality of stroke in DM patients is two-fold higher than that of non-diabetic patients. 7. Diabetes can result in widespread macrovascular atherosclerosis and microcirculatory disorders of multiple organs.