基于UPLC-MS骨质疏松症阴虚证临床代谢标志物筛查研究

目的 筛查“肝肾阴虚证”原发性骨质疏松症患者的血清小分子差异代谢物。方法 筛选门诊符合“肝肾阴虚”证型的患者。通过纳入排除标准,筛选出肝肾阴虚组（I组）、正常组（CK组）各30例。运用UPLC-MS技术检测两组受试者血清小分子代谢物,并进行差异分析,筛选肝肾阴虚证型的差异代谢物。结果 共鉴定出小分子代谢物6 478个。初始筛选标准为OPLS-DA模型第一主成分的VIP > 1,t检验的P < 0.05。筛选I-CK组差异代谢物418个。进一步筛选标准为：①VIP > 1;②P＜0.05;③log2(FC) > 1 或者 < ?1;④Fragment score ≠ 0。共筛选出15个肝肾阴虚证差异性代谢物（氨基酸类6个：甘氨胆酸、苯丙氨酸、亮氨酸、异亮氨酸、蛋氨酸、氨基吡唑基丙酸;生物碱类2个：茶碱,骆驼蓬总碱;胆红素类2个：胆红素、(4E,15Z)-胆红素;磷脂类1个：溶血磷脂酰乙醇胺;恶唑类1个：2-甲基-4-戊氯恶唑;酚酯类1个：二苯氧苯胺;低聚肽类1个：乳基谷胱甘肽;二萜类1个：15-O DC。结论 筛选出骨质疏松症阴虚证的潜在临床代谢标志物,可用于下一步代谢通路研究。提示代谢组学技术在探索传统中医理论本质及中医药临床研究方面,具有较为广泛的应用前景。     

糖尿病患者尿微量蛋白变化与胰岛素抵抗关系的探索

目的 探讨尿微量清蛋白(mAlb),尿β2微球蛋白(β2-MG)在2型糖尿病肾病(DN)中的变化及与胰鸟素抵抗(IR)的关系.方法 检测95例2型糖尿病(T2DM)患者和25例健康体检者的尿mAlb、尿β2-MG、空腹血糖(FPG)、空腹胰岛素(F1NS),用改进稳态模型计算胰岛素抵抗指数(Homa-IR),观察各指标在不同病程中的变化,比较相同病程中各指标阳性率,分析Homa-IR与尿mAlb和β2-MG的相关性.结果 糖尿病组mAlb、β2-MG、FPG、F1NS和Homa-IR显著高于对照组;10年以上病程各指标均显著高于5年以下病程,5～10年病程的mAlb、β2-MG和FPG也显著高于5年以下病程,差异有统计学意义(P＜0.01,P＜0.05);5～10年病程和10年以上病程各指标阳性率差异无统计学意义,但5年以下病程中β2-MG阳性率显著高于mAlb、F1NS和Homa-IR的阳性率也显著高于mAlb,差异有统计学意义(P＜0.01);Homa-IR与尿mAlb和β2-MG呈正相关.结论 IR与T2DM肾损伤的尿微量蛋白有关,尿mAlb和β2-MG是早期诊断DN的灵敏指标,在DN初期,尿β2-MG灵敏度高于尿mAlb.     

两种方法治疗慢性分泌性中耳炎的疗效比较

目的 探讨鼻内镜下行咽鼓管置管术治疗慢性分泌性中耳炎的疗效,并观察和分析咽鼓管咽口形态与分泌性中耳炎的关系.方法 将慢性分泌性中耳炎患者73例(88耳)随机分成置管组和对照组,分别行鼻内镜下的咽鼓管置管术和传统的咽鼓管吹张术,术后随访3个月,比较两组疗效.结果 置管组38例(45耳):治愈17耳,占37.8%,好转21耳,占46.6%,总有效率84.4%;对照组35例(43耳):治愈8耳,占18.6%,好转22耳,占51.2%,总有效率69.8%.治疗后两组治愈率差异有显著性意义(P＜0.05).结论 鼻内镜下咽鼓管置管术具有微创、安全、简单、疗效好等特点,是治疗慢性分泌性中耳炎的一个良好方法;咽鼓管咽口形态可分五种类型,与分泌性中耳炎有着密切的联系.     

Egg-hatching inhibition in mice immunized with recombinant Schistosoma bovis 28 kDa glutathione S-transferase

The capacity of a recombinant glutathione S-transferase from Schistosoma bovis (rSb 28GST) to protect BALB/c mice against homologous and heterologous infections with, respectively, S. bovis or Schistosoma mansoni has been studied. Two injections of the rSb 28GST and an intravenous boost resulted in a marked specific IgG response on the day of experimental challenge with S. bovis or S. mansoni cercariae. Immunization of BALB/c mice led to a reduction in egg maturation and egg viability after infection with S. bovis or S. mansoni. Adult worm recoveries after an S. bovis challenge infection and tissue egg densities (intestine and liver) in S. mansoni challenge infection were also reduced in the immunized groups, but these differences were not statistically significant. No association between in vitro inhibition of GST enzymatic activity induced by immunized mouse sera and worm burden reduction was recorded. The analysis of the immune response, on the day of perfusion, showed the production of immunoglobulin (Ig)G1, IgG2a and IgG2b specific antibodies and the production of interleukin (IL)-4 and IL-5 by spleen cells after rSb 28GST stimulation. These data suggest that rSb 28GST immunization induces a moderate effect upon egg maturation and egg hatching, suggesting the involvement of similar mechanisms of action and common, but not exclusive, targets during S. bovis and S. mansoni infections. As a consequence, immunization with rSb 28GST may prove useful in affecting the pathology and transmission of African schistosomes.     

Oxidative stress in systemic lupus erythematosus and allied conditions with vascular involvement.

OBJECTIVE: To evaluate the occurrence and clinical significance of lipid peroxidation (oxidative stress) in rheumatic diseases characterized by vascular involvement. PATIENTS AND METHODS: Plasma 8-epi-PGF2alpha (oxidative stress marker) was measured by gas chromatography-mass spectrometry in 36 patients with systemic lupus erythematosus (SLE), 13 with systemic sclerosis (SSc), 13 with systemic vasculitis [Wegener's granulomatosis (WG), n = 4; Churg Strauss syndrome (CSS), n = 3; Behcet syndrome, n = 6], 12 with rheumatoid arthritis (RA) and in 23 healthy controls (n = 23). RESULTS: 8-epi-PGF2alpha levels were higher in patients with SLE (P = 0.007), SSc (P < 0.001) and vasculitis (P = 0.001) than in controls. In SLE, a positive Coombs' test and arterial hypertension independently predicted 8-epi-PGF2alpha concentrations (P = 0.004 and P = 0.001, respectively). SLE patients not taking prednisolone showed higher 8-epi-PGF2alpha concentrations than SLE patients on prednisolone (P = 0.02). In the latter group, a dose response relationship was noted between 8-epi-PGF2alpha and steroid dosage (r = 0.6, P = 0.0003). In WG and CSS, 8-epi-PGF2alpha concentrations correlated with disease activity (r = 0.8, P = 0.01) and were higher than in patients with Behcet disease (P = 0.003). CONCLUSIONS: Oxidative stress may be pathogenetically relevant in some autoimmune rheumatic diseases with vascular involvement. Amelioration of some clinical manifestations of these diseases may be envisaged by targeting lipid peroxidation with dietary or pharmacological antioxidants.     

烧伤对垂体—睾丸轴影响的临床研究

目的探讨烧伤对垂体—睾丸轴功能的影响。方法采用 RIA 法测定了28例男性烧伤患者伤后30天内血清卵泡生成素(FSH)、黄体生成素(LH)、睾酮(T)及雌二醇(E_2)水平的动态变化。结果烧伤后血清 FSH、LH、T 水平明显降低,伤后2周左右开始有所回升,而 BSA>30％TBSA 两组患者,伤后30天仍未完全恢复正常水平;E_2水平伤后明显增高,尔后逐步下降至正常水平;死亡组平均 T 水平显著低于存活组,平均 E_2水平显著高于存活组。结论烧伤后垂体功能本身可能受抑制,E_2、T 之间的失衡有可能参与烧伤免疫抑制过程,E_2、T 水平变化幅度随烧伤严重程度增加而加剧,是反映烧伤程度较为敏感的指标。