Plasma SCF/c-kit Levels in Patients with Dipper and Non-Dipper Hypertension

Objective The aim of this study was to investigate the relationship between peripheral plasma stem cell factor (SCF)/c-kit levels and the types of dipper and non-dipper hypertension in hypertensive patients. Methods This cross-sectional study included newly diagnosed hypertensive patients who underwent 24-hour ambulatory blood pressure monitor (ABPM) between January 2009 and 2012 in Jiangning city. Patients were divided into the dipper group and the non-dipper group according to ABPM measurements. The levels of SCF and its receptor c-kit, tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) in peripheral blood were measuredvia enzyme-linked immunosorbent assays. The serum levels of glucose and lipid were examined as well. The levels of SCF/c-kit were compared between the dippers and the non-dippers; and their correlation with 24-hour mean systolic blood pressure (MSBP), 24-hour mean diastolic blood pressure (MDBP), TNF-α and IL-6 were investigated using linear regression analyses statistically. Results A total of 247 patients with newly diagnosed hypertension were recruited into the study, including 116 non-dippers and 131 dippers. The levels of peripheral plasma SCF were higher in non-dipper group (907.1±52.7ng/L vs. 778.7±44.6 ng/L;t=2.837,P<0.01), and the levels of c-kit were higher in non-dipper group too (13.2±1.7μg/Lvs 9.57±1.4μg/L; t=2.831,P<0.01). Linear regression analysis revealed that SCF/c-kit levels were significantly positively correlated with MSBP, MDBP, plasma TNF-α, and IL-6 levels (allP<0.01). Conclusions Peripheral plasma SCF/c-kit levels are higher in patients with non-dipper hypertension than those with dipper one, and significantly correlate with 24-hour MSBP, 24-hour MDBP, serum TNF-α and IL-6 levels.     

EFFECTS OF GLUCAGON ON ISLET β CELL FUNCTION IN PATIENTS WITH DIABETES MELLITUS

Objective To evaluate islet β cell response to intravenous glucagon(a non-glucose secretagogue)stimulation in diabetes mellitus.Methods Nineteen patients with type 1 diabetes(T1D)and 131 patients with type 2 diabetes(T2D)were recruited in this study.T2D patients were divided into two groups according to therapy:36 cases treated with insulin and 95 cases treated with diet or oral therapy.The serum C-peptide levels were determined at fasting and six minutes after intravenous injection of 1 mg of glucagon.Results Both fasting and 6-minute post-glucagon-stimulated C-peptide levels in T1D patients were significantly lower than those of T2D patients(0.76±0.36 ng/mL vs.1.81±0.78 ng/mL,P<0.05;0.88±0.42 ng/mL vs.3.68±0.98 ng/mL,P<0.05).In T1D patients,the C-peptide level after injection of glucagon was similar to the fasting level.In T2D,patients treated with diet or oral drug had a significantly greater fasting and stimulated C-peptide level than those patients received insulin therapy(2.45±0.93 ng/mL vs.1.61±0.68 ng/mL,P<0.05;5.26±1.24 ng/mL vs.2.15±0.76 ng/mL,P<0.05).The serum C-peptide level after glucagon stimulation was positively correlated with C-peptide levels at fasting in all three groups(r=0.76,P<0.05).Conclusions The 6-minute glucagon test is valuable in assessing the function of islet β cell in patients with diabetes mellitus.It is helpful for diagnosis and treatment of diabetes mellitus.     

Increased serum and ascitic fluid levels of soluble tumor necrosis factor-p55 in hepatocellular carcinoma patients

Objective: To explore the levels of serum and ascitic fluid soluble tumor necrosis factor receptor-p55 (sTNFR-p55) and understand their clinical implication in primary hepatocellular carcinoma (HCC) patients. Methods: Enzyme-linked immunosorbent assay (ELISA) was used to examine the levels of sTNFR-p55 in the serum and ascitic fluid in 25 HCC patients and 25 patients with liver cirrhosis (LC). The test was also performed on the serum of 30 healthy subjects who served as control group. To assess the clinical effects of increased serum concentrations of sTNFR-p55, four parameters were analyzed by logistic regression. Results: Serum and ascitic fluid levels of sTNFR-p55 in HCC patients were significantly higher than those in LC patients and controls (P=0. 001). No significant difference was found between serum sTNFR-p55 levels in the latter 2 groups (P = 0. 19), and positive correlation between serum levels of sTNFR-p55 and that in ascitic fluid was noted in the 2 patient groups (r=1. 000, P<0. 001). Level     

Correlations between serum uric acid level and disease activity, intrathecal inflammation reactivity in patients with multiple sclerosis

Objective To explore the correlations between serum uric acid(UA) levels and the clinical and cerebrospinal fluid(CSF) parameters of multiple sclerosis(MS).Methods The medical reports of 47 MS patients admitted to Peking Union Medical College Hospital during 2008 and 2010 were reviewed.And 49 age-and gender-matched cerebral infarction patients were enrolled as control.The mean serum UA level of the MS patients was compared with that of the control group.The correlations between the UA levels and the clinical parameters including gender,disease duration,relapse rate,and disease disabilities as assessed by the Expanded Disability Status Scale score,were explored.Forty-one patients had CSF examinations.The correlations between the UA levels and the CSF parameters reflecting inflammation and tissue damage,including CSF protein,white blood cell count,oligoclonal band,24-hour IgG index,and myelin basic protein,were also investigated.Results The mean serum UA level in the MS patients was lower than that in the control group(247.75 ± 52.59 μmol/L vs.277.94 ± 74.33 μmol/L,P=0.025) and inversely correlated with the relapse rate(P=0.049).MS patients with lower serum UA levels tended to have higher white blood cell counts and myelin basic protein level.But there was no correlation between CSF protein levels(r=0.165,P=0.273),white blood cell counts(r=-0.051,P=0.732),IgG index(r =0.045,P=0.802),or myelin basic protein level(r =-0.248,P=0.145) and the serum UA level,respectively.Conclusion In MS patients,UA levels might partly reflect the extent of disability and inflammation.     

Changes of plasma beta-endorphin levels before and after percutaneous transvenous mitral commissurotomy in patients with mitral stenosis.

To clarify the contribution of left atrial pressure to the secretion of beta-endorphin, we have investigated the relation between plasma beta endorphin levels and hemodynamic changes in 35 patients with mitral stenosis undergoing percutaneous transvenous mitral commissurotomy (PTMC). Before PTMC, plasma beta-endorphin levels obtained from the antecubital vein (28.91 ± 5.59 pg / ml) and from the femoral vein (28.20 ± 5.44 pg / ml) in the patients with mitral stenosis were significantly higher than those obtained from the antecubital vein in the healthy volunteers (22.59 ± 3.86 pg / ml, n = 34, P< 0.001 for each). The levels of beta-endorphin in the femoral vein correlated well with the mean left atrial pressure (r=0.777, P< 0.001) and the mean right atrial pressure (r = 0.450, P<0.01) before the procedure. The antecubital venous levels of beta-endorphin in patients in New York Heart Association functional Classess Ⅱ (26.45 ± 5.39 pg / ml, n = 20) and Ⅲ (32.20 ± 4.02 pg / ml, n = 15) were significan     

Impact of luteinized unruptured follicles on endometrial receptivity

This study examined the impact of luteinized unruptured follicle (LUF) on endometrial receptivity. The menstrual cycle of 17 LUF patients (LUF group) and 13 ovulatory women (control group) was monitored by measuring LH level in urine and by ultrasonic examination. An endometrial biopsy at the sixth to tenth day after LH surge was taken in all the patients. The expressions of endometrial ER, PR and integrin ανβ3 were immunohistochemically determined. At the same time, the serum levels of E2 and P were detected by chemiluminescence. The results exhibited that (1) The mean serum P level in LUF group (7.32±2.56 ng/mL) was significantly lower than that in control group (11.17±3.17 ng/mL) (P<0.01). But there was no significant difference in the mean serum E2 levels between LUF group (179.35±81.60 pg/mL) and the control group (198.58±75.23 pg/mL) (P>0.05); (2) The mean expression intensities of ER, PR in endometrium of LUF group (183.86±2.43, 167.94±3.04) were significantly higher than those in control group (109.35±6.31, 105.98±4.07) (P<0.01); (3) The mean expression intensities of integrin ανβ3 in endomtrium of LUF patients (114.90±11.38) were significantly lower than those in control group (191.34±1.82) (P<0.01); (4) The change profile of integrin ανβ3 expression in the endometrium of LUF patients was in positive relation with serum P level (r=0.77, P<0.01), but bore no significant relationship with serum E2 level (r=0.01, P>0.05). It was concluded that the depression of serum P levels in LUF patients was closely related to the failure of the down-regulation of ER and PR, and the low expressions of integrin ανβ3 also suggested that the delayed implantation and the impaired endometrial receptivity had impact on embryonic implantation.     

不同时机连续性肾脏替代治疗对多脏器功能障碍综合征患者的影响

目的 研究不同的时机进行连续性肾脏替代治疗(CRRT)对多脏器功能障碍综合征(MODS)患者血清细胞因子及预后的影响.方法 2008年7月至2010年10月江苏大学附属人民医院综合ICU收治并行CRRT治疗的MODS患者34例,根据患者发生MODS到进行CRRT治疗的时间为0～3 d的归为早期组16例,4～10 d的归为晚期组18例.两组MODS患者除CRRT治疗外,均给予常规治疗.两组患者在CRRT治疗前(0 h)及治疗后6、12、18、24、48、72 h测定血清6种细胞因子的水平:白细胞介素(IL)-1β、白细胞介素-1受体拮抗剂(IL-1Ra)、IL-6、肿瘤坏死因子(TNF)-α、可溶性肿瘤坏死因子受体1(sTNFR1)和IL-10,同时进行动态APACHEⅡ评分.结果 (1)早期组在72 h较0 h血清IL-1β、IL-6、IL-10水平明显降低,IL-1Ra及IL-1Ra/IL-1β比值明显升高(P<0.05).晚期组血清IL-1β、IL-6、TNF-α、IL-10的水平的降低,IL-1Ra及IL-1Ra/IL-1β比值的升高,主要集中出现在最初的24 h内(P<0.05).在72 h早期组血清IL-10水平明显低于晚期组[(25±12) ng/L比(51±33) ng/L] (P<0.05),而IL-1Ra及IL-1Ra/IL-1β比值明显高于晚期组[分别为(1382±899) ng/L比(683±188) ng/L,(54±10)比(23±6)] (均P<0.05).(2)早期组0 h APACHEⅡ评分明显低于晚期组(P<0.05),早期组72 h APACHEⅡ评分较0 h明显降低(P<0.05),晚期组差异无统计学意义.两组0 h脏器功能障碍数≥4个的患者数差异无统计学意义,早期组7 d脏器功能障碍数≥4个的患者数较0 h明显下降(P<0.05),晚期组差异无统计学意义.结论 调节抗炎/致炎因子的比值是CRRT调节免疫状态的关键,在MODS发生早期行CRRT治疗能够获得更大的临床收益.

Abstract：

Objective To explore the effects of continuous renal replacement therapy (CRRT) on serum cytokines and prognosis in multiple organ dysfunction syndrome (MODS) patients based on different therapeutic opportunities. Methods A total of 34 MODS patients in the treatment of CRRT after admission to ICU of our hospital between July 2008 and October 2010 were recruited. Based on the time interval from the onset of MODS to the initiation of CRRT, the patients were stratified into early group (0-3 days, n=16) and late group (4-10 days, n=18). Both groups of MODS patients received conventional treatment in addition to 72 hours of high-volume hemofiltration (HVHF). The serum levels of such inflammatory mediators as interleukin (IL)-1β, interleukin-1 receptor antagonist (IL-1Ra), IL-6, tumor necrosis factor (TNF)-α, soluble tumor necrosis factor receptor1 (sTNFR1) and IL-10 were detected by enzyme linked immunosorbent assay (ELISA) before CRRT (0 h) and 6, 12, 18, 24, 48 and 72 h during the treatment of CRRT. Dynamic APACHEⅡ scores were also evaluated. Results (1) The early group had lower serum levels of IL-1β, IL-6, IL-10 and higher IL-1Ra, L-1Ra/IL-1β ratio at 72 h than those of 0 h (P<0.05). And the late group had a declining serum level of IL-1β, IL-6, TNF-α and IL-10 and a rising ratio of IL-1Ra and IL-1Ra/IL-1β during the first 24 h (P<0.05). As compared with the late group, the early group had a lower level of IL-10 [(25±12) vs (51±33) ng/L] and higher ratios of IL-1Ra and IL-1Ra/IL-1β at 72 h [(1382±899 vs (683±188) ng/L, (54±10) vs (23±6)] (both P<0.05). (2) The early group had a lower APACHEⅡscore than the late group at 0 h (P<0.05). APACHEⅡscore at 72 h was significantly lower than 0 h in the early group. And there was no obvious change in the late group. There was no statistical difference in the numbers of MODS patients with dysfunctional organs number ≥ 4 at 0 h in both groups. The number of MODS patients with dysfunctional organs number ≥ 4 at 72 h was lower than 0 h in the early group (P<0.05). And there was no statistical difference in the late group. Conclusion Regulating the ratio of anti-inflammatory/pro-inflammatory mediators is critical in the immunomodulation of CRRT. And CRRT may provide more clinical benefits in the early phase (0-3 days) of MODS.     

Cerebrospinal Fluid Biomarkers in Dementia Patients with Cerebral Amyloid Angiopathy

Objective To study the changes of biomarkers in cerebrospinal fluid (CSF) in cerebral amyloid angiopathy (CAA) dementia and Alzheimer's disease. Methods Levels of amyloid proteinβ (Aβ42, Aβ40) and phosphorylated Tau-protein (P-tau) in CSF and ratio of Aβ42/Aβ40 were tested in 5 cases with CAA dementia and 20 cases with Alzheimer's disease collected at Peking Union Medical College Hospital from December 2001 to March 2011. Results The levels of Aβ42, Aβ40, and P-tau in CSF and ratio of Aβ42/Aβ40 were (660.4±265.2) ng/L, (7111.0±1033.4) ng/L, (71.8±51.5) ng/L, and 0.077±0.033, respectively in CAA dementia and (663.6±365.6) ng/L, (5115.0±2931.1) ng/L, (47.7±38.8) ng/L, and 0.192±0.140, respectively in Alzheimer's disease patients. There were no statistically significant differences between CAA dementia and Alzheimer's disease in terms of these CSF biomarkers (allP>0.05). Conclusion Measurements of CSF biomarkers may not be helpful in differential diagnosis of CAA and Alzheimer's disease.     

VARIATION OF SERUM ACTIVIN A LEVEL IN PATIENTS WITH LIVER CIRRHOSIS

Objective To evaluate the variation of serum activin A level in liver cirrhotic patients.Methods 83 liver cirrhotic patients (32 Child-Pugh A, 30 Child-Pugh B and 21 Child-Push C) and 32 normal subjects entered the study. The serum levels of activin A, procollagen Ⅲ peptide and collagen Ⅳ were measured by ELISA. Results Compared with those of normal subjects (0. 76±0. 31ng/ml) ,the serum activin A levels were significantly increased in liver cirrhotic patients(1. 33±0. 83ng/ml, P <0. 01). The levels were higher in Child-Pugh C (1. 45±0. 39ng/ml, P <0. 01) and B( 1. 47±0. 81ng/ml, P <0. 01) than in Child-Pugh A (1.00±0. 35 ng/ml) and normal control group(0. 76±0. 31ng/ml). There was no significant difference between Child-Pugh B and C patients or between Child-Pugh A patients and normal control. In corresponding Child-Pugh grades, the serum activin A levels of those suffering from hepatic encephalopathy, digestive tract hemorrhage, infection or ascites were not different from those without such c     

Increased circulating myostatin in patients with type 2 diabetes mellitus

The changes of plasma myostatin levels in patients with type 2 diabetes mellitus(T2D) and their clinical correlation were investigated.We recruited 43 T2D patients and 20 age-matched healthy subjects.Plasma myostatin,lipid and glucose,and serum insulin were determined.T2D patients showed significantly higher fasting plasma glucose(FPG),serum insulin and triglyceride levels,and lower high-density lipoprotein levels than normal control subjects(P<0.01).Mean plasma myostatin level in T2D patients and health controls was(66.5±17.8) and(46.2±13.8) ng/mL,respectively.An unpaired t test showed that the increase of myostatin in the T2D patients was significant(P<0.001).In both healthy control and T2D groups,the female subjects showed higher myostatin levels than the male subjects.In the T2D patients,plasma level of myostatin was negatively correlated with body mass index(BMI,r=-0.42,P<0.01) and FPG(r=-0.51,P<0.01),but positively correlated with insulin resistance index(HOMA-IR,r=0.48,P<0.01).Up-regulation of plasma myostatin in the T2D patients and its correlation with BMI,FPG and blood insulin sensitivity suggests that plasma myostatin may be implicated in the pathogenesis of T2D and thus presented as a therapeutic target for treating the disease.Furthermore,circulating myostatin levels may be used as a biomarker for the disease.     

多发性肌炎及皮肌炎患者血清单核细胞趋化蛋白-1的测定及临床意义

目的:检测多发性肌炎/皮肌炎(polymyosits/dermatomyosits,PM/DM)患者血清中单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)的水平,分析其在PM/DM中的临床意义。方法:采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)方法测定100例PM/DM患者、20例肺部感染患者以及42名健康对照者血清中MCP-1水平,分析PM/DM患者临床表现及预后与血清MCP-1水平的相关性。结果:血清MCP-1浓度在合并肺间质疾病(interstitial lung disease,ILD)的PM/DM组、未合并ILD的PM/DM组、肺部感染组和正常对照组的平均值分别是(1 869±1 590)ng/L、(1 349±1 303)ng/L、(493±255)ng/L和(256±144)ng/L。PM/DM患者血清MCP-1水平高于肺部感染组及正常对照组(P均<0.001),合并ILD的PM/DM组血清MCP-1水平较未合并ILD的PM/DM组、肺部感染组和正常对照组均显著升高(P均<0.01)。血清MCP-1的升高与肺间质病变存在显著关联性(χ2=9.6,P<0.01)。MCP-1诊断PM/DM合并ILD的敏感性为60.7%、特异性为68.2%。MCP-1升高组中,发热、关节炎、一氧化碳弥散量(%DLCO)下降的发生率以及血红细胞沉降率、C反应蛋白、血清铁蛋白水平均较MCP-1正常组明显升高(P均<0.05)。相关性分析显示,PM/DM患者血清MCP-1水平与血清铁蛋白呈显著正相关(r=0.488,P<0.001)。结论:MCP-1在PM/DM患者血清中表达增高,并与合并ILD密切相关,可用于鉴别肺部感染和肺间质病变,具有重要临床意义。     

妊娠期肝内胆汁淤积症外周血IL-12及TNF-α检测的临床意义

目的 观察妊娠期肝内胆汁淤积症(ICP)患者外周血清肿瘤坏死因子α(TNF-α)和白介素12(IL-12)的水平,探讨其与患者临床发病程度及围产结局的相关性.方法 选取本院产科2013年1月至2015年1月收治的113例ICP患者,根据发病程度分为三组:轻度ICP 31例、中度ICP 52例、重度ICP 30例,并以同期入院的101例健康孕产妇为对照组;抽取各组孕产妇清晨空腹外周血,采用ELISA试剂盒测定其血清TNF-α和IL-12的水平.结果 对照组、轻度ICP、中度ICP、重度ICP的IL-12水平分别为(8.22±1.05)ng/L、(27.2±3.25)ng/L、(46.5±3.83)ng/L、(66.3±5.24)ng/L,TNF-α水平分别为(31.2±4.52)ng/L、(67.2±6.25)ng/L、(82.3±7.79)ng/L、(126±13.2)ng/L,各组之间的差异均有统计学意义(P<0.01);ICP患者剖宫产率为61.1%(69/113),剖宫产患者IL-12、TNF-α水平分别为(62.3±7.35)ng/L、(93.2±11.4)ng/L,阴道分娩患者的分别为(58.3±6.04)ng/L、(87.5±10.7)ng/L,组间比较差异均有统计学意义(P<0.05);ICP患者不良妊娠结局发生率为35.4%(40/113),不良妊娠结局患者IL-12、TNF-α水平分别为(67.3±7.06)ng/L、(119±13.0)ng/L,正常妊娠者分别为(40.2±5.89)ng/L、(86.5±9.37)ng/L,组间比较差异均有统计学意义(P<0.01).结论 IL-12及TNF-α水平与ICP的发病程度呈正相关,可作为围产结局的预测指标.     

慢性肾脏病患者血清HIF-1α、TGF-β1与肾小管间质纤维化及疾病进展的关系

  目的  探讨血清缺氧诱导因子-1α(HIF-1α)、转化生长因子(TGF-β1)与肾小管间质纤维化(TIF)在慢性肾脏病(CKD)患者中的变化及其对疾病进展预测价值。  方法  选择2019年1月—2020年12月温州市中西医结合医院肾内科收治的CKD患者158例,根据肾小球滤过率(eGFR)值对CKD患者进行分期:1期(38例)、2期(42例)、3期(30例)、4期(28例)、5期(20例),另选取健康体检者40例为对照组,收集各组临床资料及血液样本,应用酶联免疫吸附法(ELISA)检测CKD患者血清HIF-1α、TGF-β1水平,采用Masson染色评估TIF面积。  结果  CKD 1~5期患者HIF-1α[依次为(25.48±4.26)ng/mL、(30.98±5.36)ng/mL、(35.88±6.78)ng/mL、(42.25±5.63)ng/mL、(68.96±6.98)ng/mL]、TGF-β1[依次为(3.98±0.36)ng/mL、(5.23±0.45)ng/mL、(6.78±0.63)ng/mL、(8.96±1.52)ng/mL、(12.97±2.98)ng/mL]显著高于对照组[(12.78±0.69)ng/mL和(1.22±0.15)ng/mL,均P < 0.05]。经Pearson相关性分析显示,血清HIF-1α、TGF-β1与血清CysC、Scr、TIF面积呈正相关(均P < 0.05)。经ROC曲线分析可知,血清HIF-1α、TGF-β1联合诊断可提高TIF诊断灵敏性及特异性。  结论  血清HIF-1α、TGF-β1水平升高与CKD病情进展及肾间质纤维化相关,并可作为CKD患者TIF病情诊断的预测指标,两者联合检测可提高诊断准确性。      

转化生长因子β1和肿瘤坏死因子α在门静脉高压症发病中的意义

目的　研究转化生长因子 β1 (TGFβ1 )和肿瘤坏死因子 α(TNFα)在门静脉高压症 (门脉高压 )发病中的作用。　方法　应用酶联免疫分析方法对 5 0例门脉高压患者 (其中 2 0例伴腹水形成 )、5 0例正常对照者进行TGFβ1 和 TNFα的检测。　结果　对照组血清 TGFβ1 和 TNFα为 12 .32± 3.2 9ng/ml,94.74± 49.30 pg/ml,门脉高压组分别为 19.2 1± 5 .87ng/ml,140 .85± 5 3.47pg/ml(P<0 .0 5 ) ;门脉高压伴腹水者为 18.44± 5 .89ng/m l,16 7.34± 38.6 2 pg/ml,不伴腹水者为 2 0 .6 8± 6 .73ng/ml,10 1.5 4± 2 8.2 4pg/m l,两者比较 TGFβ1 差异无显著性 ,而有腹水者 TNFα高于无腹水者 (P<0 .0 5 )。　结论　 TGFβ1 和 TNFα水平升高在肝硬化门脉高压发病的病理生理机制中起作用。     

多发性肌炎/皮肌炎患血清肿瘤坏死因子相关凋亡诱导配体的测定及其临床意义

目的：检测多发性肌炎/皮肌炎（PM/DM）患者血清肿瘤坏死因子相关凋亡诱导配体（sTRAIL）的水平及其在多发性肌炎/皮肌炎中的临床意义.方法：采用酶联免疫吸附法（ELISA）检测2012年10月～2013年8月中日友好医院风湿免疫科40例PM/DM患者,20例健康人血清中sTRAIL的水平.分析sTRAIL水平与PM/DM各临床特点的关系.结果：PM/DM患者组血清sTRAIL水平为1380.71±126.49ng/L,显著高于健康对照组493.89±33.32ng/L（P＜0.05）.吞咽困难的PM/DM患者血清sTRAIL水平（1775.76±321.95ng/L）显著高于无吞咽困难者（958.24±155.66ng/L,P＜0.05）.是否合并肺间质病变,其血清sTRAIL水平无显著性差异（P＞0.05）.Jo-1阳性的患者组血清sTRAIL水平为562.36±52.99ng/L,显著低于Jo-1阴性的患者组1334.57±181.21ng/L（P＜0.05）.PM/DM患者血清sTRAIL水平与乳酸脱氢酶（LDH）显著负相关（r=-4.03,P＜0.05）.结论：TRAIL在多发性肌炎/皮肌炎的发病机制中起作用,其异常表达与患者的临床特征密切相关.     

依那普利对老年糖尿病合并高血压患者血清APN、血浆AngⅡ和Leptin水平的影响

目的：观察老年糖尿病(DM)合并高血压(HT)患者血清脂联素(APN)、血浆血管紧张素Ⅱ(AngⅡ)及血浆瘦素(Leptin)水平的变化,并探讨血管紧张素转换酶抑制剂依那普利对其影响。方法选择2013年12月至2015年12月在我院门诊就医的老年DM血压正常患者(A组)和老年DM合并HT患者(B组)各50例,以体检健康老年人50例作为对照组(C组),测定并比较三组受检者的血清APN和血浆AngⅡ和Leptin水平,并观察依那普利对老年DM合并HT患者血清APN和血浆AngⅡ和Leptin水平的影响。结果与C组[APN (7.79±1.28) mg/L、AngⅡ(55.62±8.98) ng/L、Leptin (9.18±2.13) ng/mL]相比,A组[APN (5.25±1.27) mg/L、AngⅡ(92.51±14.79) ng/L、Leptin (16.88±2.97) ng/mL]和B组[APN (3.21±1.53) mg/L、AngⅡ(152.12±21.56) ng/L、Leptin (24.89±4.96) ng/mL] DM患者血清APN明显降低、血浆AngⅡ升高、Leptin水平明显升高,差异均具有统计学意义(P<0.05)。B组患者血清APN与其MAP呈负相关(r=-0.56,P<0.05);血浆AngⅡ与患者MAP呈明显正相关(r=0.69, P<0.05);Leptin水平与MAP呈明显正相关(r=0.59,P<0.05);血清APN与血浆AngⅡ则呈现显著负相关(r=-0.55,P<0.05)。老年DM合并HT患者应用依那普利治疗后,患者在血压降低的同时其血清APN明显升高[治疗前(3.21±1.53) mg/L,治疗后(6.53±0.91) mg/L], AngⅡ[治疗前(152.12±21.56) mg/L,治疗后(106.32±18.94) mg/L]和Leptin水平[治疗前(24.89±4.96) mg/L,治疗后(18.33±3.28) mg/L]明显降低,差异均具有统计学意义(P<0.05)。结论血清APN降低、血浆AngⅡ和Leptin水平升高可能是老年DM发生HT的重要原因;依那普利可使老年DM合并HT患者血清APN水平明显降低,AngⅡ和Leptin水平明显升高。     

缺氧诱导因子1-α及血管内皮生长因子与2型糖尿病微血管并发症的关系

目的探讨2型糖尿病（T2DM）微血管并发症患者血清血管内皮生长因子（VEGF）和缺氧诱导因子-1α（HIF-1α）水平的变化及其意义。方法对T2DM组108例和健康体检者30人进行研究,根据尿白蛋白排泄率将糖尿病患者分为正常白蛋白尿组（40例）、微量白蛋白尿组（36例）和临床白蛋白尿组（32例）。测定各组血清VEGF、HIF-1α、胆固醇、三酰甘油、肌酐、空腹血糖和胰岛素等,并进行比较。结果 T2DM患者正常白蛋白尿组、微量白蛋白尿组、临床白蛋白尿组的VEGF水平分别为（382.66±50.83）、（452.37±61.35）、（582.29±52.76）ng/L,HIF-1α分别为（78.33±21.02）、（98.46±32.55）、（120.17±31.46）pg/L,均显著高于对照组的（301.18±51.26）ng/L和（52.17±17.38）pg/L（P〈0.01）;VEGF和HIF-1α水平均随尿白蛋白排泄率的增加而增加。结论 T2DM患者体内高水平的血清VEGF和HIF-1α可能在微血管并发症的发生发展过程中有重要作用。     

CRP、IL-6和TNF-α与糖尿病肾病关系的研究

目的 探讨不同程度的糖尿病肾病(DN)与高敏C-反应蛋白(HS-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平的关系.方法 根据糖尿病(DM)患者是否伴有24h尿白蛋白(UAE)以及UAE的含量,将DM组分成无肾病DM组、轻度DN组和重度DN组.检测并分析141例2型糖尿病(T2DM)患者和54例...