RAAS系统在继发性高血压疾病中的应用进展

在人体体内分布最广泛的内分泌调节系统是肾素-血管紧张素-醛固酮系统(renin-angiotensin-aldosteron system,RAAS),该系统在内分泌调节环节中发挥着至关重要的作用.在内分泌系统中,可以通过RAAS来实现对人体体内血量流动和外周阻力的控制,并且还可以通过RAAS来进一步调节体内血压、水和电解质的平衡,确保人体环境能够保持在一个稳定的状态.组成RAAS的主要部分有肾素、血管紧张素和醛固酮.针对RAAS各个组成部分进行深入研究之后,发现在RAAS系统中的一些部分与嗜铬细胞瘤、副神经节瘤等继发性高血压疾病密切相关.通过检测RAAS的组分可以辅助诊断因RAAS系统失调所导致的多种疾病.本文将从RAAS组分的检测方法及其在继发性高血压中的临床应用进行综述.     

Effect of once-daily fluticasone furoate nasal spray on nasal symptoms in adults and adolescents with perennial allergic rhinitis.

BACKGROUND: Intranasal corticosteroids are recommended as first-line therapy for the treatment of allergic rhinitis. Fluticasone furoate is a novel enhanced-affinity glucocorticoid for the treatment of allergic rhinitis. OBJECTIVE: To compare the efficacy and safety of intranasal fluticasone furoate with those of vehicle placebo nasal spray in adult and adolescent patients with perennial allergic rhinitis (PAR). METHODS: After screening (7-14 days), patients 12 years and older with confirmed PAR were randomized to receive fluticasone furoate, 110 microg once daily, or placebo once daily intranasally for 4 weeks in this double-blind, multicenter study. The primary end point was mean change from baseline during the entire treatment period in daily reflective total nasal symptom score (rTNSS), recorded on diary cards by patients, using a 4-point categorical scale. RESULTS: The mean reduction from baseline during the treatment period in daily rTNSS was significantly greater in fluticasone furoate recipients than in placebo recipients (P = .005). This finding was supported by significantly greater mean reductions in morning rTNSS and evening rTNSS (P = .004 and P = .011, respectively). A significantly greater mean reduction in instantaneous morning predose TNSS with fluticasone furoate compared with placebo (P = .006) confirmed the efficacy of once-daily administration. Fluticasone furoate was also significantly more effective than placebo in overall response to therapy (P = .005). CONCLUSIONS: Fluticasone furoate nasal spray, 110 microg once daily, effectively relieved nasal symptoms of PAR in adults and adolescents 12 years and older.     

甲氨喋呤对胶原诱导性关节炎大鼠滑膜骨桥蛋白和整合素αVβ3表达的影响

目的 探讨甲氨喋呤对胶原诱导性关节炎(collagen-induced arthritis,CIA)大鼠滑膜骨桥蛋白(osteopontin,OPN)及其受体整合素αvβ3表达的影响及其作用机制.方法 建立CIA大鼠模型,分为模型组和甲氨喋呤(MTX)组,后者用MTX进行干预治疗;采用免疫组织化学染色技术检测滑膜组织OPN和整合素αvβ3的表达,ELISA方法检测血清TNF-α水平.结果 ① CIA模型组和MTX组大鼠的滑膜OPN、整合素αvβ3表达均明显高于正常大鼠对照组(均为P<0.01);与模型组比较,MTX组OPN和整合素αVβ3的表达减少(均为P<0.01). ②正常对照组和MTX组大鼠血清TNF-α水平显著性低于模型组大鼠(均为P<0.01).结论 滑膜OPN和整合素αvβ3异常表达在CIA发病中具有重要意义.MTX通过下调滑膜OPN和整合素αvβ3的表达,降低血清TNF-α水平从而达到治疗CIA的作用.     

Evidence-based patient choice: a prostate cancer decision aid in plain language

Background  

Decision aids (DA) to assist patients in evaluating treatment options and sharing in decision making have proliferated in recent years. Most require high literacy and do not use plain language principles. We describe one of the first attempts to design a decision aid using principles from reading research and document design. The plain language DA prototype addressed treatment decisions for localized prostate cancer. Evaluation assessed impact on knowledge, decisions, and discussions with doctors in men newly diagnosed with prostate cancer.     

Monomethylfumarate affects polarization of monocyte-derived dendritic cells resulting in down-regulated Th1 lymphocyte responses

Psoriasis vulgaris, a type-1 cytokine-mediated chronic skin disease, can be treated successfully with fumaric acid esters (FAE). Beneficial effects of this medication coincided with decreased production of IFN-gamma. Since dendritic cells (DC) regulate the differentiation of T helper (Th) cells, this study focussed on effects of monomethylfumarate (MMF, bioactive metabolite of FAE) on polarization of monocyte-derived DC. MMF-incubated, lipo-polysaccharide-stimulated DC (MMF-DC) produced dramatically (p<0.05) reduced levels of IL-12p70 and IL-10 (8+/-4% and 20+/-4%, respectively) compared to control DC. MMF-DC were mature. MMF affected polarization of DC irrespective of polarization factor(s) and ligands for the various Toll-like receptors used. Coculture of MMF-DC with naive and primed allogenous Th cells resulted in lymphocytes producing less IFN-gamma, i.e. 59% and 54% of that by the respective Th cells cocultured with control DC. IL-4 production by primed, but not naive Th cells cocultured with MMF-DC was decreased as compared to cocultures with control DC. IL-10 production by naive and primed Th cells cocultured with MMF-DC and control DC did not differ. In addition, MMF inhibited LPS-induced NF-kappaB activation in DC. Together, beneficial effects of FAE in psoriasis involve modulation of DC polarization by MMF such that these cells down-regulate IFN-gamma production by Th cells.     

负载乳腺癌抗原单核细胞来源树突状细胞迁移能力的调控因素研究

目的：体外培养乳腺癌抗原负载的人单核细胞来源DC，应用不同刺激因子使其表面CCR7表达上调，在体外观察其迁移能力。方法：用rhGM-CSF和rhIL-4诱导MoDCs，并负载乳腺癌抗原后，分别与PGE2、LTC4或Bryo-1共培养，检测其表型及其功能变化。结果：PGE2、LTC4和Bryo-1在体外不影响MoDCs刺激淋巴细胞增殖能力和自体特异性淋巴细胞杀伤活性。与对照组MoDCs相比，PGE2和LTC4作用MoDCs后CD86表达增高，可以上调CCR7 mRBA和蛋白表达（P〈0．05）。PGE2可以使MoDCs对其配体CCL19和CCL21反应性增强（P〈0．05），而LTC4仅能使MoDCs对CCL19反应性增强。Bryo-1虽然可以促进MoDCs成熟，使其CCR7 mRNA表达增强，但在CCR7蛋白表达、迁移能力方面与对照组相似。结论：以PGE2和LTC4作用MoDCs后可以通过上调其CCR7表达，促进其迁移趋化能力。     

天然生物材料构建组织工程支架的研究进展

细胞培养支架材料是组织工程的重要研究内容之一.本文综述近年来几种典型天然生物材料构建组织工程支架的研究进展,并详细介绍了适用于天然生物材料制备组织工程支架的致孔方法.     

双凤尾钢板植骨内固定治疗胸腰椎爆裂骨折的生物力学测试

目的 对双凤尾钢板治疗胸腰椎爆裂骨折进行生物力学评价和临床应用观察。方法 取成年男性尸体脊柱标本(T12-L2),制成8具L1椎体爆裂骨折模型。按实际手术方法放置双凤尾钢板。对试件分别进行轴向和弯曲扭转加载测试。临床观察应用双凤尾钢板治疗胸腰椎爆裂骨折的效果。结果 压缩实验和弯曲扭转实验中,各点应变值与载荷均呈线性关系。当轴向载荷达到600N或扭矩达到600N·cm时,这种线性关系未改变。弯扭矩与模型两端之间相对扭转角的增加呈线性关系。弯扭矩达到600N·cm时,扭转角只有6.26°。临床观察表明双凤尾钢板固定可靠。结论 双凤尾钢板固定具有良好的稳定性,表现出高弹性,符合生物学固定的原则。值得临床推广应用。     

用细胞酶联免疫吸附法筛选分泌抗人B细胞分化抗原单抗的杂交瘤

用活化的人Ｂ细胞株３Ｄ５细胞免疫ＢＡＬＢ／Ｃ小鼠，取小鼠脾脏细胞与ＳＰ２／０细胞融合，融合后细胞置甲基纤维素半固体培养基生长。以０．５％甲醛处理的３Ｄ５细胞和ＣＥＭ细胞包被酶细胞反应阳性而与ＣＥＭ细胞反应阴性的克隆。再经间接免疫荧光染色后，用流式细胞仪复测以上所得３３个阳性克隆，结果３Ｄ５阳性ＣＥＭ阴性者２７例，占８１．８２％，表明ＣＥＬＩＳＡ法是一个粗筛抗人Ｂ细胞分化抗原的简便有效方法。     

高血压病患者血清IGFⅡ的变化

目的 :探讨胰岛素样生长因子Ⅱ (IGFⅡ )与高血压病 (EH)以及与高血压伴左室肥厚 (EH伴LVH)的关系。方法 :采用放射免疫分析 10 0例未治疗的EH患者和 5 0例正常人血清IGFⅡ水平。并用彩色多普勒诊断仪测定 10 0例EH患者的左心室重量 (LVM )。结果 :EH患者血清IGFⅡ水平明显高于正常人[(0 6 6± 0 35 )ng/ml:(0 4 4± 0 14 )ng/ml,p <0 0 1],EH伴LVH者IGFⅡ高于EH非LVH者 [(0 82± 0 4 0 )ng/ml:(0 5 4± 0 2 0 )ng/ml,p <0 0 1]。结论 :EH患者IGFⅡ水平升高 ,其升高程度与病情密切相关 ,IGFⅡ可能参与了EH心肌肥厚的形成