扩张型心肌病抗心肌β1与M2受体自身抗体的初步研究

目的研究抗β１与抗Ｍ２受体的自身抗体是否与扩张型心肌病（ＤＣＭ）有关。方法以心脏β１与Ｍ２受体细胞外第二环表位肽段的合成肽作为抗原，应用酶联免疫吸附测定（ＥＬＩＳＡ）技术检测５２例ＤＣＭ患者和４１例正常人血清中抗β１与Ｍ２受体的自身抗体。结果ＤＣＭ患者血清中有２２例（４２．３％）与２９例（５５．８％）的抗β１与抗Ｍ２受体的自身抗体，均显著高于正常人血清中仅５例（１２．２％）与４例（９．８％）相应抗体的检出（Ｐ＜０．０１）；ＤＣＭ患者血清中抗β１与Ｍ２受体的自身抗体滴度分别为１１０３与１１２８，远高于正常人１４０与１２４的相应抗体滴度（Ｐ＜０．０１）；心功能Ⅱ～Ⅲ级的阳性率是心功能Ⅳ级的２倍以上且抗体滴度大多在１１６０～１２５６０，而心功能Ⅳ级的抗体滴度全部在１２０～１８０。患者血清中抗β１与抗Ｍ２受体自身抗体的出现呈显著正相关（ｒ＝０．９６）。结论ＤＣＭ患者不仅存在抗心肌β１和Ｍ２的自身抗体而且他们的抗体滴度也明显高于正常对照组。     

Residual high-grade angina after enhanced external counterpulsation therapy

OBJECTIVE: We evaluated the degree of residual angina on the outcomes of enhanced external counterpulsation (EECP) therapy for chronic stable angina. BACKGROUND: Angina refractory to medical therapy is common in the pool of patients who are not completely revascularized by angioplasty or bypass surgery. METHODS: We examined 902 patients enrolled from 1998 to 2001 in the Second International Enhanced External Counterpulsation Patient Registry. Baseline and outcome variables were stratified by the last recorded Canadian Cardiovascular Society class. RESULTS: Residual Class 3 (12.1%) or 4 (2.3%) angina was uncommon among patients with severe coronary artery disease after treatment with EECP. Prevalence of diabetes, hypertension, dyslipidemia, and heart failure was similar among the anginal post-EECP anginal classes. Multivessel coronary disease was more common in those with higher-grade angina at completion. More frequent and severe angina at entry was more common in those with the higher anginal classes at EECP (P<.001). There were no differences in the rates of chronic medications utilized or prior revascularization. At 3-year follow-up, rates of death, myocardial infarction, percutaneous coronary intervention, and coronary artery bypass surgery tended to be higher across increasing residual angina classes. The composite cardiac event rates were 34%, 33%, and 44% for those with Class 0, Class 1/2, and Class 3/4 angina at EECP completion (P=.01), respectively. Multivariate analysis for the composite endpoint found residual Class 3/4 angina (OR=1.59, 95% CI=1.19-2.17, P=.002), diabetes (OR=1.57, 95% CI=1.23-2.01, P=.0003), age (per decile OR=1.17, 95% CI=1.04-1.31, P=.007), and greater EECP augmentation (OR=0.79, 95% CI=0.65-0.96, P=.02) as significant predictors. CONCLUSIONS: Residual high-grade angina after EECP occurs in those with more severe angina and multivessel disease at baseline and is associated with cardiac events over the next 3 years. These data suggest that close clinical observation and intensive management of those with high-grade angina post-EECP are warranted.     

pSLX-CMV/TβRII-IgG1Fc载体的构建

目的构建表达人TGFβ1II型受体细胞外结合区和人IgG1Fc的融合蛋白逆转录病毒载体,为进一步肝纤维化的基因治疗奠定实验基础。方法以RTPCR方法扩增目的基因TβRIIIgG1Fc,扩增产物纯化后克隆至测序载体pGEMTEasy,挑取阳性克隆酶切鉴定后测序;利用重组DNA技术,将TβRIIIgG1Fc基因亚克隆至逆转录病毒载体pSLXCMV中,重组质粒pSLXCMV/TβRIIIgG1Fc在脂质体介导下转染PA317包装细胞,G418筛选,直至出现抗性克隆,扩大培养,测定病毒滴度。结果经测序、限制性酶切分析及PCR方法鉴定,载体插入基因序列、大小、位置均正确无误,并用PA317细胞进行包装、病毒滴度测定、筛选,建立具有较高滴度的感染性重组病毒产生细胞系。结论成功构建了重组质粒pSLXCMV/TβRIIIgG1Fc,可望为肝纤维化的基因治疗提供有效途径。     

阳离子脂质体介导的虫荧光素酶基因表达

目的 研究阳离子脂质体Lipofectin介导虫荧光素酶基因在不同细胞株中的表达。方法 质粒pDR2luc在大肠杆菌DH5a中扩增后用碱裂解法提取,并经Sepharose 2B凝胶过滤柱层析,通过凝胶电泳及紫外分光光度计分析纯度、定量,以Lipofectin分别转染人肝癌细胞株HepG2、SMMC7721、人肾癌细胞株GRC及非洲绿猴肾细胞COS7,然后以液体闪烁计数仪单光子计数法测定荧光素酶活性。结果 荧光素酶活性在4种细胞株中均有表达,且均有显著性差异(均P<0.05)。结论 阳离子脂质体Lipofectin可用于多种真核细胞基因转染。     

小鼠骨髓基质细胞的生物学特性及血管新生能力

目的 探讨体外培养的骨髓基质细胞的一些生物学特性及体内移植后在缺血区新血管生成中的作用。方法分离5—6周龄的小鼠胫骨、股骨，用预冷的DMEM／F12培养基冲洗出骨髓，经密度梯度离心分离出骨髓单个核细胞，接种后12～16d形成单层贴壁的成纤维样细胞。体外诱导分化鉴定分离的细胞，用传代的细胞进行生长曲线测定，观察其接种贴壁率、分裂指数，检测细胞周期和超微结构，并建立下肢缺血模型。荧光标记的体外扩增的骨髓单个核细胞被移植入缺血组织。移植后2周，荧光显微镜及内皮细胞碱性磷酸酶染色，检查荧光阳性细胞与染色阳性细胞的时空关系。结果体外传代培养的单个核细胞倍增时间约为42h。传代10h贴壁率达90％以上。分裂指数曲线与生长曲线相似。细胞周期显示约83％的细胞处于G1期。结论 体外培养的骨髓基质细胞生长稳定，传代后的细胞适应性强，增殖较快，表现出较早期细胞特点，在体外及移植入体内缺血区能分化为血管内皮细胞，有望用于改善组织缺血。     

中文版SF-36量表用于中国老年军人生活质量调查的信度与效度评价

目的 探讨美国简明健康测量量表SF-36用于中国老年军人生活质量测量的可能性。方法 采用分层、整体抽样法，使用SF-36量表中文版对西安地区934例老年军人的生活质量进行测定，参照国际生活质量评价项目的标准程序，进行正式的心理测量学试验。结果 本次研究中，SF-36量表中文版的分半信度为0．892；同质性信度系数除社会功能、心理健康2个维度，其它6个维度变化范围为0．70～0．93，满足群组比较的要求。除社会功能、心理健康维度外，其它6个维度条目的维度相关性一致；因子分析产生的8个共因子与理论结构基本一致，结构效度的累积方差贡献为68．56％。结论 SF-36健康调查量表可用于中国老年人的调查，同时提示在精神和心理方面的个别语句经进一步修订后，将提高调查的可行性及相关方面的信度和效度。     

心房肌缝隙连接蛋白40、43表达改变与心房颤动的关系

目的：研究心房颤动患者心房肌缝隙连接蛋白(Cx)40、43表达的改变，探讨Cx在房颤发生与维持中的作用。方法：39例接受开胸手术者分为房颤组和窦性心律组，手术时取右心耳及左心房各约100mg，采用Western blot与免疫组织化学技术，检测心房肌Cx40、Cx43表达量与分布的改变。结果：房颤组Cx40表达量在左心房、右心耳较窦性心律组高，Cx43表达量在左心房较窦性心律组高，在右心耳无差异。免疫组化显示房颤组Cx40、Cx43均分布紊乱，聚集于胞浆或核周。结论：房颤患者心房肌Cx40、Cx43表达增高，且分布异常，提示心房肌Cx40、Cx43表达改变与心房颤动的发生与维持有关。     

多重逆转录-聚合酶链反应方法半定量检测多药耐药基因mRNA表达

目的:建立多重逆转录-聚合酶链反应(RT-PCR)方法半定量检测肝癌多药耐药(MDR)基因mRNA的表达。方法:在对二重RT-PCR扩增5种MDR基因mRNA动力学观察及建立RT-PCR标准曲线的基础上,建立六重RT-PCR方法。结果:六重RT-PCR与单一或二重RT-PCR扩增体系在特异性和扩增效率等方面相同,实验重复性较好。结论:该方法对于检测肝癌组织和肝癌细胞MDR基因mRNA的表达具有特异、灵敏、简便、快速(6h)、所需标本量小(50mg)及半定量等优点,能快速同时分析大量样本,具有临床应用前景。     

Air pollution and cardiovascular disease: a statement for healthcare professionals from the Expert Panel on Population and Prevention Science of the American Heart Association

Air pollution is a heterogeneous, complex mixture of gases, liquids, and particulate matter. Epidemiological studies have demonstrated a consistent increased risk for cardiovascular events in relation to both short- and long-term exposure to present-day concentrations of ambient particulate matter. Several plausible mechanistic pathways have been described, including enhanced coagulation/thrombosis, a propensity for arrhythmias, acute arterial vasoconstriction, systemic inflammatory responses, and the chronic promotion of atherosclerosis. The purpose of this statement is to provide healthcare professionals and regulatory agencies with a comprehensive review of the literature on air pollution and cardiovascular disease. In addition, the implications of these findings in relation to public health and regulatory policies are addressed. Practical recommendations for healthcare providers and their patients are outlined. In the final section, suggestions for future research are made to address a number of remaining scientific questions.