Platelet function profiles in patients with type 2 diabetes and coronary artery disease on combined aspirin and clopidogrel treatment

To assess platelet function profiles in diabetic and nondiabetic patients on aspirin and clopidogrel therapy, two patient populations were included to investigate the 1) acute effects of a 300-mg clopidogrel loading dose (group 1, n = 52) and 2) long-term effects of clopidogrel (group 2, n = 120) on platelet function in diabetic compared with nondiabetic patients already on aspirin treatment. Patients were stratified according to the presence of type 2 diabetes. Platelet aggregation was assessed using light transmittance aggregometry (groups 1 and 2). Platelet activation (P-selectin expression and PAC-1 binding) was determined using whole-blood flow cytometry (group 2). Clopidogrel response was also assessed. In group 1, platelet aggregation was significantly increased in diabetic (n = 16) compared with nondiabetic (n = 36) patients at baseline and up to 24 h following a 300-mg loading dose (P = 0.005). In group 2, platelet aggregation and activation were increased in diabetic (n = 60) compared with nondiabetic (n = 60) subjects (P < 0.05 for all platelet function assays). Diabetic subjects had a higher number of clopidogrel nonresponders (P = 0.04). Diabetic patients have increased platelet reactivity compared with nondiabetic subjects on combined aspirin and clopidogrel treatment. Reduced sensitivity to antiplatelet drugs may contribute to the increased atherothombotic risk in diabetic patients.     

Influence of preservation solution on the isolation and culture of human hepatocytes from liver grafts

A major problem for the isolation and transplantation of hepatocytes is the lack of resources for obtaining viable hepatocytes. Improving this situation would enhance hepatic cell transplantation programs. Our objective was to evaluate the influence of the preservation solutions used during organ retrieval on the quality of hepatocytes isolated from liver tissue. We compared the results of the collagenase perfusion technique for isolation of hepatocytes in human livers flushed with University of Wisconsin (UW) and Celsior preservation solutions. Yield (number of viable cells per gram of tissue), cellular viability, efficiency of cells to attach to culture plates and form a monolayer, and drug metabolizing competence of the hepatocytes were measured. Successful isolation was achieved in 63% of the procedures using the UW solution and 100% of the procedures using the Celsior solution. In the UW group, significantly lower cell viability (38 +/- 41% vs. 79 +/- 14%, p < 0.05), yield of cells (4.0 +/- 5.2 x 10(6) vs. 8.2 +/- 5.6 x 10(6) cells/g, p < 0.05), and protein content at 24 h of culture (0.6 +/- 0.6 vs. 1.2 +/- 0.3 mg protein per plate, p < 0.05) than in Celsior solution were found. However, similar values of P450 activities were found in both groups. The more successful isolation, better yield, and higher cell viability obtained from human liver grafts preserved in Celsior solution, in comparison to UW solution, suggest Celsior solution as the most appropriate for preserving cadaveric hepatic tissue to be used for hepatocyte harvesting.     

右半结肠与左半结肠肿瘤性肠梗阻一期切除吻合的比较

目的:比较右半结肠与左半结肠癌肠梗阻一期切除吻合的近期结果.方法:回顾分析80例结肠癌肠梗阻行一期切除吻合患者的临床资料.结果:37例右半结肠癌及43例左半结肠癌肠梗阳患者行一期手术,2组患者平均住院时间为(31.6±12.8)d vs(29.6±14.8)d,P=0.518,平均住院费用为(52794.9±60 804.3)元vs(50 192.8±39 727.4)元,P=0.817,并发症率分别为21.6%(8/37)vs 25.6%(11/43),P=0.678,病死率为5.4%(2/37)vs2.3%(1/44),P=0.593,差异均无统计学意义.2组中各有1例发生吻合口瘘.结论:一期切除吻合对右半或左半结肠癌肠梗阻者同样安全.左半结肠吻合前,充分的结肠减压是必须的.     

Calcium absorption and bone mineral density in celiacs after long term treatment with gluten-free diet and adequate calcium intake

Calcium malabsorption, hypocalcemia and skeletal demineralization are well-recognized features of untreated celiac disease. This study investigates calcium absorption and bone mineral density (BMD) after a prolonged, over 4 years, treatment with a gluten-free diet. Twenty-four adult females with treated celiac disease and twenty age- and sex-matched control subjects were studied. Mean body mass index (MBI), energy intake, serum calcium, and serum 25(OH)D concentrations in treated celiacs did not differ from controls. However, while both dietary calcium and protein intake were significantly higher in celiacs (P<0.012), fractional calcium absorption was lower (mean percentage±SD; treated 39.8±12 versus controls 52.3±10, P<0.001). Thus, after adjusting for calcium intake, the estimated amount of calcium absorbed daily was similar in both groups. Whole body, spine and trochanter BMD were significantly lower in treated celiac patients compared with controls (P<0.05). There were significant inverse correlations between: serum parathyroid hormone (PTH) and femoral neck or total body BMD (P<0.01), PTH and duration of gluten-free diet (P=0.05), and fractional calcium absorption and alkaline phosphatase (P=0.022). Increased calcium intake could potentially compensate for the reduced fractional calcium absorption in treated adult celiac patients, but may not normalize the BMD. In addition, the inverse correlation between PTH and time following treatment is suggestive of a continuing long-term benefit of gluten withdrawal on bone metabolism in celiac patients.     

Markers of inflammation before and after renal transplantation

BACKGROUND: This study aims to compare serum C-reactive protein (CRP), interleukin (IL-6), and tumor necrosis factor (TNF)-alpha in end-stage renal disease (ESRD) patients before versus after receiving renal transplantation (RT) and versus donors. METHODS: Serum samples from 37 ESRD patients (24 male, age 34+/-13 years) were collected before and after RT; in addition, samples from 31 donors were obtained at transplantation. CRP concentrations were measured using nephelometry, and TNF-alpha and IL-6 were measured by enzyme-linked immunoadsorbent assay. RESULTS: Ninety-two percent of recipients had a living donor, 73% received cyclosporine A, 27% tacrolimus, and 70% induction with daclizumab. Thirteen percent had acute rejection and 16% chronic allograft nephropathy. All inflammation markers decreased 6 months after RT, but only CRP was below baseline values (baseline: 5.0+/-3.5; 6 months: 3.0+/-0; 12 months: 3.2+/-0.7; 18 months: 3.2+/-0.6; donors: 3.6+/-1.5 mg/L; P<0.05), whereas median TNF-alpha (baseline: 0.1 [0.03-0.2]; 6 months: 0 [0-0.1]; 12 months: 0.3 [0.1-2.6]; 18 months: 0.6 [0.1-1.9]; donors: 0 [0-0.1] pg/mL; P<0.05) and IL-6 (baseline: 1.9 [1.2-7.1]; 6 months: 1.2 [0.6-28.3]; 12 months: 2.6 [1.3-3.4]; 18 months: 2.7 [1.7-4.2]; donors: 1.1 [0.6-1.9] pg/mL; P<0.05) significantly increased up to the end of follow-up. Before RT, CRP correlated with age (r 0.45, P=0.006) and albumin (r -0.36, P=0.04). TNF-alpha and IL-6 were correlated before (r 0.34, P=0.04) and after (r 0.55, P=0.02) RT. Inflammation markers were not different in patients who had acute rejection episodes or chronic nephropathy. CONCLUSIONS: Compared with controls, patients displayed an inflammatory phenomenon before receiving RT. Serum CRP decreased significantly after RT, whereas TNFalpha and IL-6 increased.     

新型冠状病毒肺炎诊疗的若干思考

作为一种新发的传染性极强的呼吸道疾病,新型冠状病毒肺炎（COVID-19,以下简称新冠肺炎）在全球范围内传播、蔓延。目前,该病已经造成了数以百万计的人感染、近30万人死亡,严重威胁着人类生命财产安全等众多方面。本文通过在临床治疗过程中对该疾病特点及疾病演变规律的总结,为新冠肺炎的诊治提供参考。     

乳腺癌术后患者心理社会适应水平调查研究

目的 探讨乳腺癌患者心理社会适应水平现状,并分析其与生活质量的相关性,为提高乳腺癌患者生活质量提供新的方向。方法 选取2020年9月至2021年6月新疆某三甲医院就诊的264例乳腺癌患者作为研究对象,采用一般资料调查问卷、乳腺癌心理社会适应问卷、乳腺癌患者生命质量问卷进行调查,分析乳腺癌患者心理社会适应水平与生活质量的相关性。结果 乳腺癌患者心理社会适应水平得分为(147.59±17.59)分,生活质量得分为(95.83±15.04)分;相关性分析结果显示,乳腺癌患者心理社会适应水平得分与生活质量总分呈正相关(r=0.379,P<0.001);多元分层回归结果显示,心理社会适应水平进入生活质量影响因素模型,心理社会适应水平可独立解释乳腺癌生活质量14.70%的变异。结论 乳腺癌患者疾病心理社会适应处于中低水平,且与生活质量呈正相关,疾病心理社会适应水平是其生活质量的重要预测因子。     

组蛋白修饰影响肿瘤血管生成的研究进展

组蛋白修饰是表观遗传调控的一种重要方式,它通过相关修饰酶发生翻译后修饰从而改变染色质的结构和功能.肿瘤血管生成是肿瘤发生、发展、转移、复发过程中至关重要的一个环节.已有大量研究发现,组蛋白修饰和肿瘤血管生成有着密切联系,组蛋白修饰酶可以改变自身表达量或者直接作用于癌基因,也可以与热休克蛋白等相互作用促进或抑制肿瘤血管生...     

酒精性肝病啮齿动物模型建立的研究进展

酒精性肝病（alcoholic liver disease, ALD）是全世界最常见的肝脏疾病之一,由于长期酗酒引起肝脏发生一系列病理改变,最终导致肝脏疾病的发生,且发病率逐年上升。目前,酒精性肝病的发生机制及病理研究已经取得了显著进展,但ALD的相关机制并未研究透彻,需要通过改进目前现有的动物模型或建立一种新的更全面的ALD动物模型去模拟人类ALD。ALD的实验动物模型,特别是啮齿类动物,已被广泛用于模拟人类ALD,理想的酒精性肝病啮齿动物模型将有效地模拟酒精对人类肝脏的方方面面。但到目前为止,常用的动物模型都存在一定缺陷,还没有一个完整的动物模型能够模拟人类ALD。本文对ALD发病机制、ALD啮齿动物模型建立的相关方法及其影响因素进行了综述,为相关科研人员建立ALD啮齿动物模型提供理论依据。     

HAART drugs induce mitochondrial damage and intercellular gaps and gp 120 causes apoptosis

HIV-1 infection is associated with serious cardiovascular complications, but the roles of HIV-1, viral proteins, and highly active antiretroviral therapy (HAART) drugs are not understood. HAART decreases the overall risk of heart disease but leads to metabolic disturbances and possibly coronary artery disease. We investigated toxicities of HIV-1, HIV-1 glycoprotein 120 (gp120), and HAART drugs for human coronary artery endothelial cells (CAECs), brain microvascular endothelial cells, and neonatal rat ventricular myocytes (NRVMs). HIV-1 and gp120, but not azidothymidine (AZT), induced apoptosis of NRVMs and CAECs. Ethylisothiourea, an inhibitor of nitric oxide synthase, inhibited apoptosis induction by gp120. AZT, HIV-1, and gp120 all damaged mitochondria of cardiomyocytes. HAART drugs, AZT, and indinavir, but not HIV-1, produced intercellular gaps between confluent endothelial cells and decreased transendothelial electrical resistance. In conclusion, HIV-1 and gp120 induce toxicity through induction of cardiomyocyte and endothelial cell apoptosis. HAART drugs disrupt endothelial cell junctions and mitochondria and could cause vascular damage.