冠心病合并2型糖尿病女性患者血清尿酸与冠状动脉病变程度的关系

目的 探讨冠心病合并2型糖尿病(T2DM)女性患者血清尿酸(SUA)水平与冠状动脉(冠脉)病变程度的关系。方法 选取经冠脉造影检查确诊的冠心病女性患者263例(冠心病组,其中合并T2DM 91例),根据SUA四分位数水平将冠心病组患者再分为A组(SUA≤231.5μmol/L)、B组(231.5μmol/L326.5μmol/L)。同期住院的非冠心病女性患者67例作为对照组。检测各组SUA及HbA1c水平,采用Gensini评分评价冠心病组冠脉病变程度,分析SUA及HbA1c水平与冠脉病变程度的关系。结果 与对照组相比,冠心病组SUA及HbA1c水平增高(P<0.01)。冠心病组中,T2DM患者的SUA水平及Gensini评分均高于非T2DM患者(P<0.01)。A组Gensini评分低于B、C、D组(P<0.01);B组Gensini评分均低于C组和D组(P<0.05或P<0.01);C组Gensini评分低于D组(P<...     

冠心病合并2型糖尿病患者冠状动脉造影结果分析

目的 探讨冠心病(CHD)合并2型糖尿病(NIDDM)患者冠状动脉(冠脉)造影特点.方法 对126例冠心病合并2型糖尿病患者(DM)及与之配对的非糖尿病冠心病患者(CHD)189例进行临床表现和血管造影资料对照分析.结果 DM组与CHD组两组间3支病变比较差异有统计学意义(P<0.05).DM组3支病变发生率高于CHD组,两组均以RCA病变发生率比较差异有统计学意义(P<0.05),即DM组RCA病变的发生率高于CHD组(P<0.05).结论 冠心病合并2型糖尿病患者高血脂比例较高,冠脉病变广泛且复杂.     

糖化血红蛋白(HbA1c)和冠脉病变复杂程度的相关性

目的探讨血清HbA1c水平和冠心病患者病变复杂程度的关系。方法对116例冠脉造影患者,根据病史分为单纯冠心病组(n=46)、冠心病合并糖尿病组(n=38)及对照组(n=32),并根据冠脉造影结果分为单支病变组(n=31)、双支病变组(n=27)和多支病变组(n=23)和对照组(n=35),根据冠脉造影行Gensini评分。比较HbA1c水平与冠脉病变的相关性。结果血清HbA1c水平病变组间有差异,随着冠脉程度增加,与Gensini积分呈显著正相关(r=0.314,p0.001)。结论 HbA1c水平与冠脉病变程度及危险因素有相关性,对冠心病患者的病变预测有较好的临床意义。     

血清hs-cTnT和Hcy及维生素B12在冠心病冠脉病变严重程度评估中的作用

目的 分析血清高敏心肌肌钙蛋白(hs-cTnT)、同型半胱氨酸(Hcy)及维生素B12(VB12)诊断评估冠心病(CHD)患者冠脉病变严重程度的临床价值。方法 选取郑州市第三人民医院2020年3月—2021年10月收治70例CHD患者为例,按照Gensini评分进行分组,其中A组(轻度,<30分,n=25例),B组(中度,30～60分,n=21例),C组(重度,>60分,n=24例),比较三组血清hs-cTnT、Hcy、VB12水平及与CHD患者冠脉病变严重程度的相关性。结果 C组血清hs-cTnT、Hcy水平高于B组、A组,VB12低于B组、A组(P<0.05)。经多因素logistic分析,血清HCY、hs-cTnT、VB12水平为CHD患者冠脉病变进展的独立危险因素(P<0.05)。CHD患者冠脉病变严重程度与血清HCY、hs-cTnT呈正相关,与VB12呈负相关。结论 CHD患者冠脉病变严重程度与血清HCY、hs-cTnT、VB12水平存在一定相关性。     

冠心病合并2型糖尿病患者临床和冠脉造影特点分析

目的 探讨冠心病(CHD)合并2型糖尿病(DM)患者的临床和冠脉造影特点.方法 选择经冠脉造影证实的冠心病患者515例,根据是否合并糖尿病将其分为糖尿病组(353例)和非糖尿病组(162例),比较两组患者的临床和冠脉造影资料.结果 合并2型糖尿病的冠心病患者发生高血压和急性心肌梗死的比例明显高于非糖尿病的冠心病患者(P＜0.01),前者血甘油三酯水平也明显高于后者(P＜0.01).冠心病合并2型糖尿病患者多发生多支病变,左主干病变也明显高于非糖尿病者(P＜0.01).结论 冠心病合并2型糖尿病患者临床和冠脉病变复杂.     

血浆同型半胱氨酸水平与冠心病患者冠脉病变程度的相关性研究

目的 探讨血浆同型半胱氨酸(Hcy)水平与冠心病患者冠脉病变程度的关系.方法 选取2014年7月至2015年7月因心绞痛行冠状动脉造影的162例患者.其中冠心病患者112例作为观察组,非冠心病患者50例作为对照组.测定2组血浆Hcy水平.根据冠状动脉造影情况评价冠脉病变程度,采用Spearman等级相关性分析和Pearson线性相关性分析检验血浆Hcy水平与冠脉病变程度之间的关系;采用多因素Logistic回归分析检验血浆Hcy水平对冠心病的影响.结果 观察组血浆Hcy水平明显高于对照组,差异有统计学意义(P＜0.05);冠脉正常患者、单纯冠脉斑块患者、单支病变患者、双支病变患者、三支病变患者、冠脉闭塞患者血浆Hcy水平逐渐升高,差异有统计学意义(P＜0.05),Spearman等级相关性分析:血浆Hcy水平与冠脉病变程度呈正相关(r =0.564,P＜0.05);Pearson线性相关分析:血浆Hcy水平与冠脉病变程度评分(Gensini评分)呈正相关(r=0.673,P＜0.05);吸烟、SBP、TC、LDL-C、Hcy是冠心病的独立影响因素(P＜0.05).结论 冠心病患者血浆Hcy水平越高,冠脉病变程度越严重,Hcy水平是冠心病的独立影响因素.     

冠心病合并2型糖尿病患者ST段改变及冠状动脉造影的临床研究

目的研究冠心病合并糖尿病患者心电图ST段改变情况及冠状动脉造影的临床病变特点。方法以冠心病(CHD)合并2型糖尿病(DM)81例为DM组,不合并糖尿病的冠心病患者314例为对照组,回顾性分析两组心电图ST段改变及冠脉造影的病变特点。结果 DM组与对照组比较心电图ST段改变分别为37.0%、34.4%两者比较无统计学差异,冠脉造影DM组受累血管病变血管支数,狭窄程度、弥漫性病变及小血管病变与对照组比较,χ2分别为18.7、35.7、35.7、5.82(P均<0.05)均有统计学差异。结论冠心病合并糖尿病患者血管病变累及范围广,狭窄程度严重,病变特征多以弥漫性和小血管病变为主。     

血清GGT、CysC及脂代谢指标水平与2型糖尿病合并冠心病的关联性分析

目的：探讨血清γ谷氨酰胺转移酶(GGT)、胱抑素C(CysC)及脂代谢指标在2型糖尿病(T2DM)合并冠心病患者中的水平，并分析T2DM患者血清GGT、CysC及脂代谢指标水平与冠状动脉病变严重程度的相关性。方法：选取2021年1月—2022年1月某院行冠状动脉造影术检查的T2DM患者132例为研究对象，按照冠状动脉造影结果分为合并冠心病组(n=79)和未合并冠心病组(n=53),比较2组血清GGT、CysC及脂代谢指标水平，并分析血清GGT、CysC及脂代谢指标水平与冠状动脉病变严重程度的相关性，以及对T2DM患者合并冠心病的预测价值。结果：合并冠心病组TG、TC水平[(2.08±0.59)mmol/L、(4.55±1.12)mmol/L]与未合并冠心病组[(1.93±0.55)mmol/L、(4.33±0.95)mmol/L]比较，差异无统计学意义(P>0.05)。合并冠心病组血清GGT、CysC、LDL-C水平及Gensini评分[(1.63±0.31)U/L、(1.34±0.42)mg/L、(2.52±0.77)mmol/L、(47.67±15.11)分]高于未合并冠心病...     

绝经女性胱抑素C与冠心病的相关性研究

目的 探讨绝经女性血清胱抑素C(Cystatin C,CysC)与冠心病的相关性。方法 185例疑诊冠心病而行冠脉造影的绝经女性被纳入研究,应用免疫比浊法测定血清CysC水平,从冠心病病情程度、病变支数和Gensini评分3方面探讨绝经女性血清CysC与冠心病之间的关系。结果(1)病变组血清CysC水平高于对照组;(2)随着血清CysC的升高,冠心病患者病情程度逐渐加重,病变支数和Gensini评分逐渐增加;(3)血清Cys C水平与冠脉病变Gensini评分呈正相关(r=0.643,P<0.05),多元逐步回归结果显示在校正了年龄、HDL 等因素之后,CysC与冠脉病变Gensini评分(β= 0.266 ,P<0.05)仍然独立相关。结论 在绝经女性中,冠心病患者血清CysC水平升高,随着血清CysC升高,患者病情程度、冠脉病变程度也更加严重。     

绝经后女性冠心病患者趋化因子CCL5水平与冠状动脉病变程度的相关性

目的:探讨绝经后女性冠心病患者趋化因子CCL5水平与冠状动脉病变程度的相关性。方法:以绝经后女性冠心病患者(CHD组,n=44)和健康志愿者(对照组,n=44)为研究对象,检测两组受试者血清CCL5、高敏C反应蛋白(hs-CRP)水平,冠状动脉造影检查并采用Gensini评分评价CHD组患者冠状动脉病变程度,临床症状分级采用加拿大心血管协会(CCS)分级法,分析CHD组血清CCL5、hs-CRP水平与病变程度及临床分级的相关性。结果:与对照组比较,CHD组血清CCL5((42.5±8.21)vs(88.1±10.21)μg/L,P0.05)、hs-CRP((0.45±0.14)vs(5.42±2.13)mg/L,P0.05)水平显著升高;CHD组血清CCL5、hs-CRP水平与病变血管数量、Gensini评分及CCS分级呈正相关(P0.05);此外,血清水平CCL5与hs-CRP水平无显著相关性(P0.05)。结论:绝经后女性冠心病患者CCL5水平升高,与冠脉病变程度及临床分级呈正相关,可作为冠脉病变程度预测和CHD筛查的血清学指标。     

Mitochondrial Biology and Neurological Diseases

Mitochondria are extremely active organelles that perform a variety of roles in the cell including energy production, regulation of calcium homeostasis, apoptosis, and population maintenance through fission and fusion. Mitochondrial dysfunction in the form of oxidative stress and mutations can contribute to the pathogenesis of various neurodegenerative diseases such as Parkinson’s (PD), Alzheimer’s (AD), and Huntington’s diseases (HD). Abnormalities of Complex I function in the electron transport chain have been implicated in some neurodegenerative diseases, inhibiting ATP production and generating reactive oxygen species that can cause major damage to mitochondriaMutations in both nuclear and mitochondrial DNA can contribute to neurodegenerative disease, although the pathogenesis of these conditions tends to focus on nuclear mutations. In PD, nuclear genome mutations in the PINK1 and parkin genes have been implicated in neurodegeneration [1], while mutations in APP, PSEN1 and PSEN2 have been implicated in a variety of clinical symptoms of AD [5]. Mutant htt protein is known to cause HD [2]. Much progress has been made to determine some causes of these neurodegenerative diseases, though permanent treatments have yet to be developed. In this review, we discuss the roles of mitochondrial dysfunction in the pathogenesis of these diseases.     

模式动物斑马鱼在神经退行性疾病研究中的应用

斑马鱼作为一种新型模式低等脊椎动物,具有发育周期短、体外受精、胚胎透明、突变种多等优势,被广泛应用于神经、心血管、消化等方面的研究中。神经退行性疾病包括帕金森病、阿尔茨海默病等,近年来发病率不断上升,且有年轻化的趋势,严重影响人们的身体健康和生活质量。因其发病机制复杂,至今仍缺乏治疗此类疾病的方法。本文综述近年来用斑马鱼制作神经退行性疾病模型的主要方式及可行性,为研究神经退行性疾病中斑马鱼模型的选择提供参考。     

头孢他定与FALL-39用于脓毒血症的疗效

目的观察FALL-39和头孢他定（CFZ）治疗脓毒血症的疗效。方法从pGEX-1λT-FALL-39转染的E.coli JM109中提纯FALL-39,检测FALL-39对绿脓杆菌（PAG）的杀菌活性。采用更生霉素（AMD）增强BALB／c小鼠对PAG感染的敏感性,建立脓毒血症模型,观察FALL-39和CFZ治疗脓毒血症的疗效。结果FALL-39分子量约5kDa,纯化量约600-650μg,对PAG的最低抑菌浓度（MIC）、最低有效浓度（MEC）、最低杀菌浓度（MBC）分别为25、100、50μg／ml。盐水组、脓毒血症组、CFZ治疗组、FALL-39治疗组和CFZ＋FALL-39治疗组小鼠死亡率分别为0％、75％、62．5％、37．5％和12．5％。结论FALL-39治疗脓毒血症比CFZ更为有效,两者联用效果则更佳。     

Clinical pharmacology = disease progression + drug action

Clinical pharmacology is concerned with understanding how to use medicines to treat disease. Pharmacokinetics and pharmacodynamics have provided powerful methodologies for describing the time course of concentration and effect in individuals and in populations. This population approach may also be applied to describing the progression of disease and the action of drugs to change disease progress. Quantitative models for symptomatic and disease-modifying effects of drugs are valuable not only for describing drugs and diseases but also for identifying criteria to distinguish between types of drug actions, with implications for regulatory decisions and long-term patient care.     

腹腔镜下巨结肠根治术治疗小儿先天性巨结肠的疗效

目的 分析腹腔镜辅助下巨结肠根治术治疗小儿先天性巨结肠的临床疗效。方法 收集2012年7月至2016年6月安徽医科大学附属省立医院收治的14例先天性巨结肠患儿的临床资料,回顾分析腹腔镜下巨结肠根治术治疗小儿先天性巨结肠的临床疗效。结果 14例先天性巨结肠患儿中,13例全腹腔镜下完成手术,1例中转开腹病例,术后平均住院（8.13±1.32）d,无腹腔镜操作相关的近期并发症,远期随访无污粪和便秘复发。结论 腹腔镜辅助下巨结肠根治术治疗先天性巨结肠安全有效,具有微创效果,值得推广。     

The influence of cannabinoids on generic traits of neurodegeneration

In an increasingly ageing population, the incidence of neurodegenerative disorders such as Alzheimer''s disease, Parkinson''s disease and Huntington''s disease are rising. While the aetiologies of these disorders are different, a number of common mechanisms that underlie their neurodegenerative components have been elucidated; namely neuroinflammation, excitotoxicity, mitochondrial dysfunction and reduced trophic support. Current therapies focus on treatment of the symptoms and attempt to delay the progression of these diseases but there is currently no cure. Modulation of the endogenous cannabinoid system is emerging as a potentially viable option in the treatment of neurodegeneration. Endocannabinoid signalling has been found to be altered in many neurodegenerative disorders. To this end, pharmacological manipulation of the endogenous cannabinoid system, as well as application of phytocannabinoids and synthetic cannabinoids have been investigated. Signalling from the CB₁ and CB₂ receptors are known to be involved in the regulation of Ca²⁺ homeostasis, mitochondrial function, trophic support and inflammatory status, respectively, while other receptors gated by cannabinoids such as PPARγ, are gaining interest in their anti-inflammatory properties. Through multiple lines of evidence, this evolutionarily conserved neurosignalling system has shown neuroprotective capabilities and is therefore a potential target for neurodegenerative disorders. This review details the mechanisms of neurodegeneration and highlights the beneficial effects of cannabinoid treatment.Linked ArticlesThis article is part of a themed section on Cannabinoids 2013. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-6     

RP-HPLC测定4，5，2’-三吗啉酰氧基-2，5'-二氯二苯甲酮原料药的含量及有关物质

目的 建立测定原料药4,5,2''-三吗啉酰氧基-2,5''-二氯二苯甲酮（LF1）的含量及有关物质的RP-HPLC方法。方法 采用Diamonsil C₁₈（250 mm×4.6 mm,5 μm）色谱柱,乙腈-磷酸水（60：40,pH3.0）为流动相,检测波长230 nm,体积流量1 mL/min,柱温25℃。结果 主峰与杂质峰分离良好,LF1和杂质A分别在质量浓度1.0~100（r=0.999 8）和0.2~2.4 mg/L （r=0.999 6）线性关系良好,最低检测限分别为1和2 ng/mL,平均回收率分别为100.7%和102.0%。结论 本法简便、快速、准确,可用于LF1原料药的含量及有关物质的测定。     

Pharmacy course on women's and men's health

Objective. To design and implement an integrated course dedicated to women''s and men''s health.Design. A women''s and men''s health module that integrated the basic and clinical sciences was developed and implemented as part of the core undergraduate pharmacy curriculum. Instruction included classroom lectures, large- and small-group case discussion, self-directed learning assignments, and case-based simulations with standardized patients, all of which focused on conditions impacting women''s and men''s health.Assessment. Assessment of student learning included multiple-choice and written examinations using case vignettes when possible, evaluation of documentation of patient care process with standardized patient interactions, and group case assignments. Students appreciated the scope of topics, the active-learning opportunities, and use of simulated patients, as well as teaching by experts in the area.Conclusion. A mandatory course in women''s and men''s health was well received by students and ensured that these important issues were addressed in the undergraduate pharmacy curriculum.     

Signs of Preclinical Wernicke's Encephalopathy and Thiamine Levels as Predictors of Neuropsychological Deficits in Alcoholism without Korsakoff's Syndrome

The purpose of this study was to determine whether meeting historical criteria for unsuspected Wernicke''s encephalopathy (WE), largely under-diagnosed in vivo, explains why some alcoholics have severe neuropsychological deficits, whereas others, with a similar drinking history, exhibit preserved performance. Demographic, clinical, alcohol related, and neuropsychological measures were collected in 56 abstinent alcoholics and 38 non-alcohol-dependent volunteers. Alcoholics were classified using the clinical criteria established by Caine et al (1997) and validated in their neuropathological study of alcoholic cases. Our alcoholics who met a single criterion were considered ‘at risk for WE'' and those with two or more criteria with ‘signs of WE''. Whole blood thiamine was also measured in 22 of the comparison group and 28 alcoholics. Of the alcoholics examined, 27% met no criteria, 57% were at risk for WE, and 16% had signs of WE. Neuropsychological performance of the alcoholic subgroups was graded, with those meeting zero criteria not differing from controls, those meeting one criterion presenting mild-to-moderate deficits on some of the functional domains, and those meeting two or more criteria having the most severe deficits on each of the domains examined. Thiamine levels were selectively related to memory performance in the alcoholics. Preclinical signs of WE can be diagnosed in vivo, enabling the identification of ostensibly ‘uncomplicated'' alcoholics who are at risk for neuropsychological complications. The graded effects in neuropsychological performance suggest that the presence of signs of WE explains, at least partially, the heterogeneity of alcoholism-related cognitive and motor deficits.