高血压患者静息心率与血压昼夜节律的相关性

目的探讨原发性高血压患者的静息心率(RHR)与血压昼夜节律的相关性。方法选择210例汉族中年原发性高血压患者,按RHR水平分为3组,RHR1组:RHR<70bpm(53例),RHR2组:70bpm相似文献   

常规电生理标测法射频消融治疗房性早搏

目的探讨导管消融治疗房性早搏(PACs)的临床疗效。方法 10例PACs病人,Holter提示24 h PACs17 957.2±4 532个,4例伴有短阵房性心动过速,根据心内激动顺序,初步确定感兴趣区域,应用激动标测法进行标测,在相对最提前部位消融,采用标准为提前≥30 ms。结果手术时间1.6±0.6 h,X线曝光时间21.6±5.4min。每例病人消融2.8±0.8(2～5)次。术后第3日Holter检查,5例病人PACs完全消失,3例病人PACs在2～12个之间,2例病人PACs分别为307及204个,此2例术前均为双源性PACs,残余均为另外一种形态的PACs。随访9.3±4.2个月,无1例复发。结论导管消融治疗PACs是安全和有效的。     

High mobility group-box 3 overexpression is associated with poor prognosis of resected gastric adenocarcinoma

AIM:To elucidate high mobility group-box 3(HMGB3) protein expression in gastric adenocarcinoma,its potential prognostic relevance,and possible mechanism of action.METHODS:Ninety-two patients with gastric adenocarcinomas surgically removed entered the study.HMGB3 expression was determined by immunohistochemistry through a tissue microarray procedure.The clinicopathologic characteristics of all patients were recorded,and regular follow-up was made for all patients.The inter-relationship of HMGB3 expression with histological and clinical factors was analyzed using nonparametric tests.Survival analysis was carried out by Kaplan-Meier(log-rank) and multivariate Cox(Forward LR) analyses between the group with overexpression of HMGB3 and the group with low or no HMGB3 ex-pression to determine the prognosis value of HMGB3 expression on overall survival.Further,HMGB3 expression was knocked down by small hairpin RNAs(shRNAs) in the human gastric cancer cell line BGC823 to observe its influence on cell biological characteristics.The MTT method was utilized to detect gastric cancer cell proliferation changes,and cell cycle distribution was analyzed by flow cytometry.RESULTS:Among 92 patients with gastric adenocarcinomas surgically removed in this study,high HMGB3 protein expression was detected in the gastric adenocarcinoma tissues vs peritumoral tissues(P 0.001).Further correlation analysis with patients' clinical and histology variables revealed that HMGB3 overexpression was obviously associated with extensive wall penetration(P = 0.005),a positive nodal status(P = 0.004),and advanced tumor-node-metastasis(TNM) stage(P = 0.001).But there was no correlation between HMGB3 overexpression and the age and gender of the patient,tumor localization or histologic grade.Statistical Kaplan-Meier survival analysis disclosed significant differences in overall survival between the HMGB3 overexpression group and the HMGB3 no or low expression group(P = 0.006).The expected overall survival time was 31.00 ± 3.773 mo(95%CI = 23.605-38.395) for patients with HMGB3 overexpression and 49.074 ± 3.648 mo(95%CI = 41.925-57.311) for patients with HMGB3 no and low-level expression.Additionally,older age(P = 0.040),extensive wall penetration(P = 0.008),positive lymph node metastasis(P = 0.005),and advanced TNM tumor stage(P = 0.007) showed negative correlation with overall survival.Multivariate Cox regression analysis indicated that HMGB3 overexpression was an independent variable with respect to age,gender,histologic grade,extent of wall penetration,lymph nodal metastasis,and TNM stage for patients with resectable gastric adenocarcinomas with poor prognosis(hazard ratio = 2.791,95%CI = 1.233-6.319,P = 0.019).In the gene function study,after HMGB3 was knocked down in the gastric cell line BGC823 by shRNA,the cell proliferation rate was reduced at 24 h,48 h and 72 h.Compared to BGC823 shRNA-negative control(NC) cells,the cell proliferation rate in cells that had HMGB3 shRNA transfected was significantly decreased(P 0.01).Finally,cell cycle analysis by FACS showed that BGC823 cells that had HMGB3 knocked down were blocked in G1/G0 phase.The percentage of cells in G1/G0 phase in BGC823 cells with shRNA-NC and with shRNA-HMGB3 was 46.84% ± 1.7%,and 73.03% ± 3.51% respectively(P = 0.001),whereas G2/M cells percentage decreased from 26.51% ± 0.83% to 17.8% ± 2.26%.CONCLUSION:HMGB3 is likely to be a useful prognostic marker involved in gastric cancer disease onset and progression by regulating the cell cycle.     

肝断面血流阻断器在肝癌切除术中的应用

目的:比较不同的肝血流阻断方法在肝切除术中应用的有效性及安全性.方法:回顾性分析我院2004-2009年117例行肝切除术的肝癌患者的相关资料.A组:自制肝断面血流阻断器局部血流控制(n=42);B组:解剖性半肝血流阻断(n=35);C组:第一肝门阻断(Pringle法,n=40).比较3组患者术中出血量和手术时间、术后肝功能的恢复以及术后并发症的发生率.结果:术中出血量和手术时间A组均明显少于B(P=0.026,P<0.001)、C(P<0.001,P<0.001)组.A组术后第3、7天肝功能(TB、ALT)的明显好于C组(TB:P=0.014,=0.009;ALT:P<0.001,P<0.001).C组术后有29例出现不同程度的腹水,术后腹水发生率显著高于A组(P<0.001);2例发生肝功能衰竭,1例出现胃肠道出血,死亡1例.结论:肝切除术中采用肝断面血流阻断器能有效控制出血、缩短手术时间,对肝功能影响小,是一种简便、安全有效的方法.     

鸟苷酸环化酶C基因沉默对人胃癌裸鼠皮下种植瘤的影响

目的:探讨鸟苷酸环化酶C(GC-C)基因沉默对人胃癌裸鼠皮下种植瘤的影响及其机制.方法:将SGC-7901细胞(SGC-7901组)、空质粒转染的细胞(PRNA组)、GC-C基因稳定沉默的细胞(GC-C-shRNA组)悬液先在裸鼠皮下接种成瘤,再取瘤组织块分别接种到裸鼠皮下,建立3种胃癌裸鼠皮下种植瘤模型.观察裸鼠一般情况、肿瘤的成瘤率、生长速度,描绘肿瘤的生长曲线,计算肿瘤的抑瘤率;采用实时荧光定量PCR(RFQ-PCR),Western blot和免疫组织化学法检测GC-C和趋化因子受体4(CXCR4)在各组移植瘤组织中的表达.结果:与SGC-7901组和PRNA组比较,GC-C-shRNA组裸鼠移植瘤生长速度明显减慢、体积明显变小(抑制率分别为33.7%、33.2%),肿瘤异型性、坏死程度明显降低,差异具有统计学意义(均P<0.05),且移植瘤组织中GC-C和CXCR4 mRNA和蛋白均明显下调(GC-CmRNA:7.47±1.70 vs 11.18±0.60,11.28±0.85;GC-C蛋白:0.52±0.15 vs 1.04±0.19,1.03±0.24;CXCR4蛋白:0.67±0.13 vs 1.02±0.21,1.03±0.23,均P<0.05).结论:GC-C基因稳定沉默在体内能保持稳定,且能抑制裸鼠移植瘤生长,该过程可能与CXCR4下调有关.     

Warfarin Therapy in the HIV Medical Home Model: Low Rates of Therapeutic Anticoagulation Despite Adherence and Differences in Dosing Based on Specific Antiretrovirals

Abstract To determine the indications for, rates of therapeutic anticoagulation during, and complications of warfarin therapy in HIV-infected individuals, in whom long-term anticoagulation is frequently indicated. To identify risk factors for nonoptimal anticoagulation and to determine if warfarin dosing is differentially affected by specific antiretroviral agents. Retrospective study of a dedicated anticoagulation program at one of the largest clinics for HIV-infected individuals in the United States. Seventy-three HIV-infected individuals on warfarin were followed for a total of 911 visits. The rate of therapeutic internation normalized ratio (INR) levels was 34.5% when including only visits at which patients were assessed to be adherent with warfarin. In multivariable analysis, injection drug use at baseline was an independent risk factor for subtherapeutic INR (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.3-4.7, p=0.01). Additionally, warfarin adherence was protective of both subtherapeutic (OR 0.4, 95% CI 0.2-0.6, p<0.0001) and supratherapeutic (OR 0.5, 95% CI 0.3-0.9, p=0.02) INR status. Efavirenz-based antiretroviral regimens were associated with lower weekly warfarin doses (46?mg) to maintain therapeutic INR compared to lopinavir/ritonavir-based regimens (68?mg; p=0.01) and atazanavir/ritonavir-based regimens (71?mg; p=0.007). Consistently therapeutic warfarin therapy is difficult to achieve in HIV-infected individuals, even with a dedicated anticoagulation program. Adherence to warfarin therapy is important but rates of therapeutic INR levels are nonetheless low. Lower warfarin dosing was required for efavirenz compared to two commonly used protease inhibitor-based regimens. Because of these factors, the emergence of new oral anticoagulants is an important development for HIV-infected individuals who require long term anticoagulation therapy.     

Early proteome analysis of rat pancreatic acinar AR42J cells treated with taurolithocholic acid 3-sulfate

BackgroundBile acids are the initiating factors of biliary acute pancreatitis. Bile acids can induce the activation of intracellular zymogen, thus leading injury in pancreatic acinar cells. Pathological zymogen activation in pancreatic acinar cells is a common feature of all types of acute pancreatitis. The proteins expressed in pancreatic acinar cells during the activation of zymogen may determine the severity of acute pancreatitis. The present study aims to determine the differentially expressed proteins in taurolithocholic acid 3-sulfate-stimulated pancreatic acinar cells as an in vitro model for acute pancreatitis.MethodsRat pancreatic acinar AR42J cells were treated with taurolithocholic acid 3-sulfate for 20 min. Laser confocal scanning microscopy and flow cytometry were used to detect activated trypsinogen in pancreatic acinar AR42J cells. After the determination of trypsinogen activation, proteome analysis was performed to identify the proteins differentially expressed in taurolithocholic acid 3-sulfate-treated cells and non-treated cells.ResultsAfter treatment with taurolithocholic acid 3-sulfate for 20 min, the activation of trypsinogen in AR42J cells was concurrent with changes in the protein expression profile. Thirty-nine differentially expressed proteins were detected; among these, 23 proteins were up-regulated and 16 proteins were down-regulated. KEGG analysis indicated that these proteins are involved in cellular metabolic pathways, cellular defensive mechanisms, intracellular calcium regulation and cytoskeletal changes.ConclusionThe expression of proteins in the pancreatic acinar cell changes at the early stage of biliary acute pancreatitis. These differentially expressed proteins will provide valuable information to understand the pathophysiologic mechanism biliary acute pancreatitis and may be useful for prognostic indices of acute pancreatitis.