动力性主动脉瓣研究近况

我们曾提出植入式左心辅助装置的一种新设想一动力性主动脉瓣。将一螺旋浆式叶轮植入到主动脉瓣位置主动旋转,在输入不同功率的条件下分别发挥机械性瓣膜或辅助性血泵两种不同的功能。该装置相当于轴流式血泵,但结构简单。装置的“转子--叶轮体”由动脉壁外的交变磁场提供动力,磁场源还可放置于体外发挥作用。动力性主动脉瓣比传统的轴流式血泵有很多潜在优点;如：体积减小,解剖相容性更好;由于引入体内的异物量很少,生物相容性将大大提高;血流的持续冲刷将提高装置的抗感染能力;完全去除供能导线的穿入体内,大大提高病人的生活质量。我们先前对动力瓣的研究揭示其原理的正确性,但功率输出急需提高。我们对动力瓣的结构进行了改进,并采用了远距离磁驱动技术。在模拟循环回路中的测试结果表明动力特性有很大提高。在最大输出条件下,流量达到5L/min,所克服的后负荷压强为70mmHg(1mmHg=0.133KPa)。动力瓣可维持的最高压强差已达131mmHg。磁驱动装置与动力瓣的距离可达60mm,显示实现体外磁驱动的可能性。此改进可大大简化植入部分的结构,进一步表明实现动力瓣设想的可行性。     

Genome-wide association study identifies breast cancer risk variant at 10q21.2: results from the Asia Breast Cancer Consortium

Although approximately 20 common genetic susceptibility loci have been identified for breast cancer risk through genome-wide association studies (GWASs), genetic risk variants reported to date explain only a small fraction of heritability for this common cancer. We conducted a four-stage GWAS including 17 153 cases and 16 943 controls among East-Asian women to search for new genetic risk factors for breast cancer. After analyzing 684 457 SNPs in 2062 cases and 2066 controls (Stage I), we selected for replication among 5969 Chinese women (4146 cases and 1823 controls) the top 49 SNPs that had neither been reported previously nor were in strong linkage disequilibrium with reported SNPs (Stage II). Three SNPs were further evaluated in up to 13 152 Chinese and Japanese women (6436 cases and 6716 controls) (Stage III). Finally, two SNPs were evaluated in 10 847 Korean women (4509 cases and 6338 controls) (Stage IV). SNP rs10822013 on chromosome 10q21.2, located in the zinc finger protein 365 (ZNF365) gene, showed a consistent association with breast cancer risk in all four stages with a combined per-risk allele odds ratio of 1.10 (95% CI: 1.07-1.14) (P-value for trend = 5.87 × 10(-9)). In vitro electrophoretic mobility shift assays demonstrated the potential functional significance of rs10822013. Our results strongly implicate rs10822013 at 10q21.2 as a genetic risk variant for breast cancer among East-Asian women.     

Gastroduodenal-splenic trunk: an anatomical vascular variant

The main classical branches of celiac trunk (CT) are the common hepatic artery (CHA), the left gastric artery (LGA) and the splenic artery (SA). During the educational dissections in a 62-year-old male cadaver a rare variation, the gastroduodenal-splenic trunk (GDST), was observed. GDST divided into SA and gastroduodenal artery (GDA). LGA and accessory left hepatic artery (ALHA) arose directly from the abdominal aorta (AA). Therefore, variations of CT are important for the clinical diagnosis and therapy.     

Molecular cloning and characterization of a receptor for activated protein kinase C1 (RACK1) from Chinese white shrimp; Fenneropenaeus chinensis

Receptor for activated C kinase 1 (RACK1), which has seven tandem WD40 domains, is a scaffolding protein. RACK1 plays different roles by binding to different partner proteins. It is involved in hormone signaling and development, and now some evidence indicates it may have a role in innate immunity. In this paper, RACK1 cDNA from Chinese white shrimp (FcRACK1) was identified. The full length of the FcRACK1 gene is 1037 bp, including a 30 bp 5′UTR, a 957 bp ORF encoding a 318 amino acid protein, and a 50 bp 3′UTR with the polyadenylation sequence AATAAA and a poly (A) tail. The FcRACK1 protein is characterized by seven WD40 repeat domains; the ending two amino acids of each WD40 domain are WK, WD, WN, WS, WD, WD, and WQ, respectively. The length of each domain is between 30 and 44 amino acids. Multiple alignments of RACK1s showed that RACK1s are highly conserved. RT-PCR showed that FcRACK1 could be detected in hemocytes, the heart, hepatopancreas, gills, stomach, intestine, and ovary. FcRACK1 in hemocytes was down-regulated after a 2 h WSSV challenge, and FcRACK1 in gills was up-regulated after a 2 h Vibrio challenge. FcRACK1 in ovary went down after a 12 h Vibrio challenge and then up-regulated at 24 h. FcRACK1 in ovary was first down-regulated at 2 h after a WSSV challenge and then up-regulated to the highest level at 6 h. It finally went down from 12 to 24 h. In hepatopancreas, FcRACK1 was also up-regulated by microbe challenge. Our results indicated its probable role in shrimp innate immunity.     

Immune responses to the oral administration of recombinant Bacillus subtilis expressing multi-epitopes of foot-and-mouth disease virus and a cholera toxin B subunit

Bacillus subtilis has been engineered successfully to express heterologous antigens for use as a vaccine vehicle that can elicit mucosal and systemic immunity response. In this study, a recombinant B. subtilis expressing the B subunit of cholera toxin (CT-B) and an epitope box constituted with antigen sites from foot-and-mouth disease virus (FMDV) type Asia 1 was constructed and named 1A751/CTB-TEpiAs. Its capability to induce mucosal, humoral, and cellular responses in mice and guinea pigs was evaluated after oral administration with vegetative cells of 1A751/CTB-TEpiAs. In addition, its capability to protect guinea pigs against homologous virus challenge was examined. All animals were given booster vaccination at day 21 after initial inoculation and guinea pigs were challenged 3 weeks after booster vaccination. The control groups were inoculated with a commercial vaccine or administered orally with 1A751/pBC38C or an oral buffer. All animals vaccinated with 1A751/CTB-TEpiAs developed specific anti-FMDV IgA in lung and gut lavage fluid, serum ELISA antibody, neutralizing antibody as well as T lymphocyte proliferation, and IFN-γ secretory responses. Three of the five guinea pigs vaccinated with 1A751/CTB-TEpiAs were protected completely from the viral challenge. The results demonstrate the potential viability of a B. subtilis-based recombinant vaccine for the control and prevention of FMDV infections.     

Acute respiratory distress syndrome leads to reduced ratio of ACE/ACE2 activities and is prevented by angiotensin-(1-7) or an angiotensin II receptor antagonist

Acute respiratory distress syndrome (ARDS) is a devastating clinical syndrome. Angiotensin-converting enzyme (ACE) and its effector peptide angiotensin (Ang) II have been implicated in the pathogenesis of ARDS. A counter-regulatory enzyme of ACE, ie ACE2 that degrades Ang II to Ang-(1-7), offers a promising novel treatment modality for this syndrome. As the involvement of ACE and ACE2 in ARDS is still unclear, this study investigated the role of these two enzymes in an animal model of ARDS. ARDS was induced in rats by intratracheal administration of LPS followed by mechanical ventilation. During ventilation, animals were treated with saline (placebo), losartan (Ang II receptor antagonist), or with a protease-resistant, cyclic form of Ang-(1-7) [cAng-(1-7)]. In bronchoalveolar lavage fluid (BALF) of ventilated LPS-exposed animals, ACE activity was enhanced, whereas ACE2 activity was reduced. This was matched by enhanced BALF levels of Ang II and reduced levels of Ang-(1-7). Therapeutic intervention with cAng-(1-7) attenuated the inflammatory mediator response, markedly decreased lung injury scores, and improved lung function, as evidenced by increased oxygenation. These data indicate that ARDS develops, in part, due to reduced pulmonary levels of Ang-(1-7) and that repletion of this peptide halts the development of ARDS.     

2型糖尿病肾病Ⅲ期的中医用药规律分析

目的分析和了解中医药治疗2型糖尿病肾病Ⅲ期的用药规律。方法选用维普咨询中文科技期刊数据库（1989-2009）、中国期刊全文数据库（CNKI）（1979-2009）、万方数据库（1982-2009）、中国生物医学文献数据库（CBM）（1990-2009）、中文生物医学期刊数据库（CMCC/CMCI）（1994-2009）为资料源,对中医药治疗2型糖尿病肾病Ⅲ期的随机对照文献的用药规律进行统计分析。结果检索到有效文献223篇,共涉及138种中药,用药频次居于前10位的是黄芪、丹参、山茱萸、山药、生地黄、川芎、茯苓、当归、益母草、大黄。药类频次统计显示,益气药居于首位,活血、养阴、收涩、清热、利水渗湿、破血逐瘀药也占了相当大的比重。结论 2型糖尿病肾病III期的中医用药多以益气养阴活血药为主,同时辅以清热、淡渗利湿、收涩固摄、化瘀泄浊、疏风解表等药,并结合临床常用经验方或药对,取得了良好的疗效。     

糖尿病肾病中医药/中西医结合研究临床治疗的研究趋向分析

目的探讨近30年来糖尿病肾病中医药/中西医结合临床治疗中医药研究的趋向及特点,为此后的中医药/中西医结合治疗糖尿病肾病提供借鉴。方法遵循循证医学评价文献的原则,以维普咨询中文科技期刊数据库（1989-2009）、中国期刊全文数据库（CNKI）（1979-2009）、万方数据库（1982-2009）、中国生物医学文献数据库（CBM）（1990-2009）、中文生物医学期刊数据库（CMCC/CMCI）（1994-2009）为资料源,全面检索1984—2009年间的糖尿病肾病治疗类文献,使用Epidta双录入数据,全部数据导出至SPSS13.0,从研究现状、特点及发展走向几个方面进行计量学评价分析。结果共检索出文献2300篇,其中涉及临床经验或个案类文章196篇、病因病机研究类53篇、辨证治疗类58篇、各中医治法治疗类117篇、自拟方及成方治疗类613篇、中成药和单味中药治疗类563篇、中药联合ACEI/ARB研究类700篇,不同类型文献起始、兴盛年份各不相同。结论临床经验或个案研究、辨证治疗研究起步较早,近年来RCT研究成为热点,不过目前RCT文献质量仍需进一步提高,设计科学、方法严谨、大样本、多中心的糖尿病肾病中西医结合RCT研究为今后重要发展方向。     

粉尘螨抗细菌活性物质的分离与鉴定

目的从粉尘螨丙酮提取液中分离抗细菌活性成分,并对其抗菌活性进行初步鉴定。方法用丙酮抽提粉尘螨,并用Sephadex G50分子筛层析进行对粉尘螨提取液中的抗细菌活性进行初步分离、纯化。对各组分的抗细菌活性进行初步鉴定。结果经Sephadex G50分子筛层析分离得到Ⅰ及Ⅱ两个峰。粉尘螨丙酮粗提物对绿脓假单胞菌无抑制作用,但对金黄色葡萄球菌、枯草芽孢杆菌及短小芽孢杆菌均有抑制作用。峰Ⅰ及峰Ⅱ则对大肠埃希杆菌、枯草芽孢杆菌、短小芽孢杆菌及金黄色葡萄球菌都有抑制作用。粉尘螨粗提液及第二个峰在加热及蛋白酶K处理后仍然保留抗细菌活性,但是第一个峰在同样处理后失去了抗菌活性。结论首次从粉尘螨分离纯化得到抗细菌成分。     

造血干细胞移植中氟康唑与伊曲康唑短疗程预防真菌感染的观察

目的比较异基因造血干细胞移植患者应用氟康唑和伊曲康唑预防侵袭性真菌感染的疗效及安全性。方法回顾分析192例异基因造血干细胞移植患者予短疗程（30d）氟康唑或伊曲康唑行真菌一级预防,其中应用氟康唑134例,伊曲康唑58例,比较两组患者侵袭性真菌感染的发生和转归情况。结果氟康唑组和伊曲康唑组移植30、60、90、180d侵袭性真菌感染的发生率分别为9.0%和5.2%、16.5%和6.9%、17.2%和8.7%、22.0%和16.4%,差异均无统计学意义（P值分别为0.370、0.081、0.128、0.309）,但移植后60d时P值明显较小。真菌感染发生部位均以肺部为主。患者均能很好耐受两药,但伊曲康唑副反应较大（19.0%vs2.2%,P=0.000）。结论短疗程伊曲康唑与氟康唑预防异基因造血干细胞移植后侵袭性真菌感染在移植60d时伊曲康唑较氟康唑显示了一定的优势。