Ficolin-3、TRF及hs-CRP联合检测在2型糖尿病早期诊断中的价值

目的 检测2型糖尿病(T2DM)患者,T2DM的期人群及健康人群血清中纤维凝胶蛋白-3 (Ficol-in-3)、转铁蛋白(TRF)、超敏C反应蛋白(hs-CRP)水平,来探讨血清中Ficolin-3、TRF及hs-CRP水平与T2DM的关系.方法 选择大连医科大学附属第一医院T2DM患者33例,T2DM前期组41(包括29例糖耐量减低者和12例空腹血糖受损者)及健康对照组30例,比较各组间Ficolin-3、TRF及hs-CRP的水平,分析3者与T2DM间的关系.结果 (1)血清Ficolin-3水平:在T2DM前期组(26.1±10.5) μg/mL及T2DM组(28.1±8.5)μg/mL均高于正常对照组(20.8±11.7 μg/mL,P＜0.05),T2DM前期组与T2DM组无显著性差异(P＞0.05);(2)血清TRF水平:T2DM前期组(261.3±51.1) mg/dL明显高于正常对照组(236.5±31.9 mg/dL,P＜0.05),T2DM组(242.0±57.7) mg/dL与正常对照组、T2DM组与T2DM前期组均无显著性差异(P＞0.05);(3)血清hs-CRP水平:T2DM组(3.12±3.47) mg/L明显高于正常对照组(1.19± 1.41) mg/L和T2DM前期组(1.70±1.97mg/L,P＜ 0.05),T2DM前期组与正常对照组无显著性差异(P＞0.05).结论 血清Ficolin-3、TRF和hs-CRP的水平可以有助于2型糖尿病的早期诊断,对T2DM的早期预防及病情发展有一定的预测价值.     

下瘀血汤干预肝硬化大鼠的蛋白质组学研究

目的 基于肝组织差异蛋白质组表达,解析下瘀血汤对硫代乙酰胺诱导的肝硬化进展期大鼠的作用及其机制。方法 48只SD雄性大鼠中的18只作为对照组,其余30只ip给予40 mg/mL的硫代乙酰胺水溶液200 mg/kg制备大鼠肝硬化模型,每周2次,连续8周;于开始造模后第4周分别随机处死对照组和造模大鼠各6只,进行药物干预前的动态观察。其余模型大鼠于开始造模后第5周首日随机分为模型组及下瘀血汤组,下瘀血汤组大鼠ig给予下瘀血汤0.626 g/kg,对照组和模型组大鼠ig生理盐水;于第8周末处死大鼠,双向凝胶电泳分离肝组织总蛋白,基质辅助激光解析电离飞行时间质谱分析鉴定部分差异表达蛋白;蛋白质免疫印迹法检测层粘连蛋白受体（67 LR）、DJ-1蛋白、Cu-Zn超氧化物歧化酶（Cu-Zn SOD）蛋白表达。结果 鉴定的18个蛋白中有5个氧化应激蛋白、5个与物质代谢相关的蛋白、4个细胞骨架蛋白、2个与炎症反应相关的蛋白、2个与增殖凋亡相关的蛋白;验证的3个蛋白点（67 LR、Cu-Zn SOD、DJ-1）与双向电泳分析结果基本一致。结论 过氧化损伤以及造成的物质代谢异常是硫代乙酰胺致大鼠肝硬化的重要病理环节,提高机体内在的抗氧化能力及逐步恢复物质代谢能力是下瘀血汤逆转大鼠肝硬化的主要机制之一。     

儿童后颅窝肿瘤合并脑积水的治疗及预后影响因素分析

目的 探讨儿童后颅窝肿瘤合并脑积水患者行肿瘤切除术前对于脑积水的治疗是否影响术后脑积水的发生率,并分析术后脑积水发生的相关危险因素.方法 中山大学附属第一医院神经外科自2003年1月至2009年12月行肿瘤切除术治疗后颅窝肿瘤合并脑积水儿童患者63例,其中对术前脑积水行保守治疗43例,手术治疗20例.回顾性分析患者的临床资料并比较术前脑积水保守治疗组和手术治疗组患者术后脑积水的发生率,Logistic回归分析患者的性别、发病年龄、术前Evans指数、肿瘤病理类型、肿瘤切除程度、肿瘤生长部位等因素是否与术后脑积水的发生有关.结果 术后出现脑积水患者22例,其中术前脑积水保守治疗组14例(14/43,32.6%),术前脑积水手术治疗组8例(8/20,40.0%),2组比较脑积水发生率差异无统计学意义(P=0.564);Logistic 回归分析发现患者术前Evans指数、肿瘤生长部位、肿瘤切除程度与肿瘤切除术后脑积水的发生有关(P=0.029,p=0.036,P=0.038).结论 肿瘤切除术前脑积水的治疗并不能改变术后脑积水的发生率:术前Evans指数、肿瘤生长部位、肿瘤切除程度是肿瘤切除术后脑积水发生的危险因素.     

慢性肾脏病患者颈-股动脉脉搏波速度改变及其影响因素

背景：有关慢性肾脏病2~5期尚未进入透析阶段患者动脉弹性功能特点的研究较少。有资料表明,颈-股脉搏波传导速度可以评价动脉弹性功能。 目的：探讨慢性肾脏病患者颈-股脉搏波传导速度的改变及影响因素。 设计、时间及地点：非随机病例对照实验,于2006-01/08在北京大学第三医院肾脏内科完成。 对象：北京大学第三医院临床情况稳定的166例慢性肾脏病患者和28名健康人。 方法：根据肾脏透析预后质量指南慢性肾脏病分期标准将患者分为轻度肾损伤组(n＝38)、中度肾损伤组(n＝54)和重度肾损伤组(n＝74),28名健康人作对照组。测定各组体质量、血压、颈-股脉搏波传导速度及生化指标,计算肾小球滤过率,比较各组间差异,并采用单因素相关和多因素回归分析探讨颈-股脉搏波传导速度的相关因素。 主要观察指标：患者颈-股脉搏波传导速度及影响因素。 结果：慢性肾脏病患者收缩压、舒张压、脉压和颈-股脉搏波传导速度明显高于对照组(P < 0.05),两组间年龄、身高、体质量、体质量指数无差异。 轻、中、重度慢性肾脏病患者年龄、体质量指数、肾小球滤过率、收缩压、脉压存在差异,随着肾脏损伤的加重,颈-股脉搏波传导速度呈明显上升趋势,年龄、收缩压及脉压也随慢性肾脏病分期的进展而增加,体重指数及肾小球滤过率呈下降趋势。除与性别因素相关外(r=2.305,P < 0.05),颈-股脉搏波传导速度与年龄(r=0.479,P < 0.001)、收缩压(r=0.556,P < 0.001)、脉压(r=0.603,P < 0.001)、血清肌酐(r=0.287,P < 0.001)和超敏C-反应蛋白(r=0.316,P < 0.001)存在显著正相关,与肾小球滤过率负相关(r=-0.436,P < 0.001)。多元逐步回归分析显示,年龄、肾小球滤过率是颈-股脉搏波传导速度独立的影响因素。 结论：慢性肾脏病患者颈-股脉搏波传导速度随着肾脏损伤的加重逐渐升高;年龄和肾小球滤过率是慢性肾脏病患者动脉硬化独立的影响因素。     

ADAS评估阿尔茨海默病的认知功能研究

目的：分析不同严重度的阿尔茨海默病(AD)患者的认知缺损特征。方法：符合DSM-Ⅳ与NINCDS-ADRDA制定的可能AD诊断标准的AD患者68例，其中轻、中、重度AD分别为27、25和16例。选择正常老人69例作为对照组。采用简明精神状态量表(MMSE)和ADAS-cog评定认知功能。结果：轻度AD组的ADAS-cog总分平均19分，中度AD组34分，重度AD组为46分。ADAS-cog总分变化比MMSE总分能更精确地反映AD患者认知功能的变化。根据项目分变化分析，轻-中度AD以记忆损害为主，重度以语言损害为主。记忆损害在中-重度期间有一个平台期，衰退减速。结论：ADAS-cog可以有效地反映AD的认知缺损，这使它可以作为抗痴呆药物疗效的判定工具，但它的缺点(如被试必须有一定的阅读能力)限制了它在国内的推广应用。     

Roles of hydroxyl and carbonate radicals in bisphenol a degradation via a nanoscale zero-valent iron/percarbonate system: influencing factors and mechanisms

In this work, nanoscale-zero-valent iron (nZVI) was applied to activate sodium percarbonate (SPC) to eliminate bisphenol A (BPA), which poses a risk to ecological and human health as a typical endocrine disruptor. The influence of nZVI loading, SPC dosing, initial pH, and the presence of inorganic anions (including Cl⁻, HPO₄²⁻, NO₃⁻ and NO₂⁻) and humic acid on BPA removal by the nZVI/SPC system were investigated. Based on the scavenger test results, ˙OH and CO₃˙⁻ participated in the degradation of BPA, and ˙OH was illustrated to be the dominant radical. The X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) analysis suggested that surface iron oxide generation, electron transfer and Fe²⁺ release were the main processes of the SPC activation by nZVI. Moreover, BPA transformation products were detected by LC-MS allowing the proposal of a possible degradation pathway of BPA. Along with the degradation of the parent compound BPA, the total organic carbon (TOC) gradually decreased, while the bio-toxicity increased at the initial stage of the reaction (0–3 min) and then decreased to a lower level rapidly at 20 min. Overall, this study evidenced the feasibility of the nZVI/SPC system to efficiently degrade BPA, broadening the applications of nZVI in wastewater treatment.

Both ˙OH and CO₃˙⁻ participated in the degradation of BPA in the nZVI/SPC system, and ˙OH was the main radical.     

Association of NEFA composition with insulin sensitivity and beta cell function in the Prospective Metabolism and Islet Cell Evaluation (PROMISE) cohort

Aims/hypothesis

Our aim was to determine the longitudinal associations of individual NEFA with the pathogenesis of diabetes, specifically with differences in insulin sensitivity and beta cell function over 6 years in a cohort of individuals who are at risk for diabetes.

Methods

In the Prospective Metabolism and Islet Cell Evaluation (PROMISE) longitudinal cohort, 477 participants had serum NEFA measured at the baseline visit and completed an OGTT at three time points over 6 years. Outcome variables were calculated using the OGTT values. At each visit, insulin sensitivity was assessed using the HOMA2 of insulin sensitivity (HOMA2-%S) and the Matsuda index, while beta cell function was assessed using the insulinogenic index over HOMA-IR (IGI/IR) and the insulin secretion-sensitivity index-2 (ISSI-2). Generalised estimating equations were used, adjusting for time, waist, sex, ethnicity, baseline age, alanine aminotransferase (ALT) and physical activity. NEFA were analysed as both concentrations (nmol/ml) and proportions (mol%) of the total fraction.

Results

Participants’ (73% female, 70% with European ancestry) insulin sensitivity and beta cell function declined by 14–21% over 6 years of follow-up. In unadjusted models, several NEFA (e.g. 18:1 n-7, 22:4 n-6) were associated with lower insulin sensitivity, however, nearly all of these associations were attenuated in fully adjusted models. In adjusted models, total NEFA, 16:0, 18:1 n-9 and 18:2 n-6 (as concentrations) were associated with 3.7–8.0% lower IGI/IR and ISSI-2, while only 20:5 n-3 (as mol%) was associated with 7.7% higher HOMA2-%S.

Conclusions/interpretation

Total NEFA concentration was a strong predictor of lower beta cell function over 6 years. Our results suggest that the association with beta cell function is due to the absolute size of the serum NEFA fraction, rather than the specific fatty acid composition.

     

红景天苷保护砷中毒大鼠左心功能:二维斑点追踪成像观察

目的 以二维斑点追踪成像（2D-STE）评估红景天苷保护砷中毒大鼠左心功能的价值。方法 将40只大鼠随机分为红景天苷高剂量组（S30组）、红景天苷低剂量组（S15组）、模型组、无毒干预组（Sal组）及对照组,每组8只。于每晨9时对S30组、S15组及模型组以As₂O₃（5 mg/kg体质量）灌胃,Sal组及对照组以无菌水灌胃,持续30天;之后对S30组以红景天苷30 mg/kg体质量、S15组及Sal组以红景天苷15 mg/kg体质量、对照组和模型组以无菌水连续灌胃7天;比较组间超声参数和血清心肌标志物差异,观察心肌组织病理改变,评价分层应变参数与血清心肌标志物的关系。结果 S30组、S15组及模型组血清肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、心肌丙二醛均高于对照组（P均<0.05）,而心肌超氧化物歧化酶、左心室射血分数（LVEF）、左心室短轴缩短率（LVFS）、各层心肌整体圆周应变（GCS）及心内膜下心肌各节段圆周应变均低于对照组（P均<0.05）;上述3组大鼠心肌细胞肿胀、坏死,细胞间隙增宽,核深染,以模型组最为明显,S30组及S15组程度相对较轻。Sal组与对照组各指标差异均无统计学意义（P均>0.05）。各组心内膜下/中层/心外膜下GCS与CK-MB （r＝－0.926、－0.813、－0.738,P均<0.05）及LDH （r＝－0.908、－0.803、－0.737,P均<0.05）均呈负相关。结论 2D-STE可用于评估红景天苷对砷中毒大鼠左心功能的保护作用。