氨基末端B型脑钠肽前体与非梗阻性肥厚型心肌病患者左心室舒张功能的相关性研究

目的探讨血浆氨基末端B型脑钠肽前体(NT-proBNP)水平与非梗阻性肥厚型心肌病(HNCM)患者左心室舒张功能的关系。方法选择46例HNCM患者,20名健康体检者作为对照组,电化学发光法检测两组血浆NT-proBNP水平,超声心动图、组织多普勒显像(TDI)检测室间隔厚度、射血分数和反映左心室舒张功能的参数。结果HNCM组患者平均NT-proBNP血浆水平明显高于对照组(P<0.001);NT-proBNP血浆水平与以下左心室舒张功能参数均呈正相关:二尖瓣室间隔侧舒张早期最大运动速度e(r=0.74,P<0.001)、e与二尖瓣室间隔侧舒张晚期最大运动速度a比值e/a(r=0.69,P<0.001)、心房收缩开始至左室流出道内心室收缩期前流速开始的间期A-Ar(r=0.63,P=0.029)、Tei指数(r=0.63,P<0.001)、肺静脉频谱收缩期肺静脉血流速度S与舒张期肺静脉血流速度D的比值S/D(r=0.62,P<0.001)、等容舒张时间(IVRT)(r=0.56,P<0.001)、二尖瓣血流频谱舒张早期充盈峰值速度E(r=0.54,P<0.001)、a(r=0.53,P<0.001)、二尖瓣血流频谱舒张晚期充盈峰值流速A(r=0.36,P=0.02)、E/A(r=0.47,P<0.001)。多因素Logistic回归分析显示,e/a、S/D是NT-proBNP血浆水平的独立影响因素。结论NT-proBNP血浆水平与超声心动图左心室舒张功能参数间存在明显的正相关性,可以作为评价HNCM患者左心室舒张功能不全的客观指标。     

甘露聚糖、壳聚糖、α-酸性糖蛋白和姜黄素对脂蛋白(a)和去唾液酸脂蛋白(a)代谢影响的对比分析

分析多糖和姜黄素对脂蛋白（ａ）和去唾液酸脂蛋白（ａ）和去唾液酸脂蛋白（ａ）代谢的影响,从刺猥腋下静脉注入甘露聚糖、壳聚糖、α－酸性糖蛋白和姜黄素,２ｍｉｎ后注射＾１２５Ｉ－脂蛋白（ａ）或＾１２５Ｉ－去唾液酸脂蛋白（ａ）,１ｈ后处死动物,测定血、肝、肾、脾、胆汁和肾上腺的同位素含量。结果发现,脂蛋白（ａ）去唾液酸后能大量进入肝脏,加速在体内的分解代谢,使血中浓度迅速降低。α－酸性糖蛋白抑制组织对脂蛋白（ａ）和去唾液酸脂蛋白（ａ）的摄入,使血中脂蛋白（ａ）和去唾液酸脂蛋白（ａ）含量显著增高。壳聚糖和姜黄素增加肝脏和肾上腺对脂蛋白（ａ）的摄取,使血中脂蛋白（ａ）含量略降低,但对去唾液酸脂蛋白（ａ）代谢无明显影响。甘露聚糖增加脾脏对脂蛋白（ａ）的摄取,减少胆囊中脂蛋白（ａ）含量,但增加肾脏和胆囊对去唾液酸脂蛋白（ａ）的     

RAW264.7巨噬细胞源性泡沫细胞模型的建立及鉴定

目的 以小鼠巨噬细胞RAW264.7为对象,建立简便而又准确的泡沫细胞诱导及鉴定方法.方法 将实验分为正常对照组和不同浓度氧化型低密度脂蛋白与细胞孵育组,在以孵育时间为24 h的前提下,用MTT法和流式细胞术来确定诱导泡沫细胞的氧化型低密度脂蛋白合适浓度区间范围,并用总胆固醇试剂盒和游离胆固醇试剂盒测定不同程度泡沫细胞内胆固醇酯含量.结果 氧化型低密度脂蛋白浓度范围为20～30 mg/L时,细胞存活率已受到显著抑制,并随着氧化型低密度脂蛋白浓度的增高细胞凋亡率和坏死率逐渐增大,起初以细胞凋亡为主,当氧化型低密度脂蛋白浓度大于40 mg/L时凋亡的细胞不断坏死.20 mg/L和30 mg/L氧化型低密度脂蛋白与RAW264.7细胞共孵育24 h,细胞内胆固醇酯比重分别为66.26%和71.19%,而10 mg/L的氧化型低密度脂蛋白诱导24 h的泡沫细胞不典型,40 mg/L以上的氧化型低密度脂蛋白诱导的泡沫细胞泡沫化程度严重,贴壁不牢,大部分细胞破裂或凋亡,脂滴散布于细胞外.结论 20～30 mg/L氧化型低密度脂蛋白诱导的RAW264.7巨噬泡沫细胞模型稳定且形态较完整,符合泡沫细胞的形态学特征.     

脂蛋白脂肪酶单克隆抗体的制备及特性

为了研究脂蛋白脂肪酶的构效关系及其在动脉粥样硬化中的病理作用机制，用牛奶纯化的脂蛋白脂肪酸免疫Balb/c小鼠通过杂交瘤技术建立了30余株分泌抗牛脂蛋白脂肪酸单克隆抗体的杂交瘤细胞。对其中2E5、2G10、6D7、8D2、7F4进行特征分析发现：①其抗体类别均为IgG，亚类分别为IgG1、IgG2b和IgG2b、IgG1、IgG1；②抗体效价为5×10-2～2×10-3；③5种单克隆抗体可认为识别三个不同的抗原表位；④West－ern－blot及Dot－blot结果显示各单克隆抗体均能识别纯化的脂蛋白脂肪酸，与人奶均无交叉反应，与牛奶显示不同的结合特征。     

刺猬体内低密度脂蛋白和脂蛋白(a)代谢途径的比较

用序列超速离心和Ｓｅｐｈａｒｏｓｅ６Ｂ凝胶柱层析获得人体低密度脂蛋白和脂蛋白（ａ），经纤维素二糖酪胺＾１２５碘标记后，从腑下静脉注入刺猬体内，３、６、１２、２４、４８、７２和９６ｈ后分别处死动物，测量血、肝、肾、脾和胆囊胆汁中放射性同位素含量。     

维持性血液透析老年患者血容量监测的意义

目的：观察血液透析过程中血容量监测对老年透析患的意义。方法：对44例患进行122次实时动态血容量监测，同时对观察容量下降值ΔBV与超滤量及心率、血压、抽搐等并发症的发生率。结果：在超滤量大致相同时，血容量下降值ΔBV无显差异，老年患血液透析并发症发生率高，特别是伴有心脏功能不良的老年透析患，并发症明显增加。结论：老年透析患在透析中进行血容量监测十分重要，伴有心脏功能不良的老年患尤其重要。     

Immunoglobulin heavy chain variable region gene usage in bone marrow transplant recipients: lack of somatic mutation indicates a maturational arrest [see comments]

Many recipients of bone marrow transplant (BMT) make normal amounts of serum immunoglobulin but are deficient in generating specific antibody responses to exogenous stimuli. To determine if abnormal usage of VH genes contributes to this immunodeficiency, the usage of VH genes was determined in peripheral blood B cells of four BMT recipients, two of whom had developed chronic graft versus host disease. The pattern of usage of VH3 or VH4 genes assessed at either 90 days or approximately 1 year after transplant was similar to that observed in healthy subjects and was marked by the over utilization of two elements, one VH3 and one VH4. However, the repertoires of each of the four BMT recipients appeared to be less complex than the repertoires of healthy subjects. The differences were a consequence of the accumulation of somatic mutations among rearrangements in the controls but not in the BMT recipients. The failure to accumulate somatic mutations in rearranged VH genes is consistent with a defect in antigen driven B-cell responses. These results indicate the although the VH gene content of the repertoire has normalized by 90 days posttransplant, a maturational arrest in B-cell differentiation associated with antigen activation persists for at least 1 year after BMT.     

Laparoscopy offers diagnosis and treatment in abdominal stab injuries

PURPOSE: To assess the role of laparoscopy in the diagnosis and treatment of abdominal stab injuries (ASI). METHODS: Patients who underwent laparoscopic procedures due to ASI were included in the study. Hemodynamic instability, injuries to the posterior trunk, concomitant severe cranial injuries, and prior abdominal operations were considered as contraindication for laparoscopy. RESULTS: From January 1997 to March 2006, 88 patients underwent laparoscopic management of ASI. In 45 patients (51.1%), there was no intra-abdominal pathology requiring surgical intervention (nontherapeutic laparoscopy) and 5 patients in this group had no peritoneal penetration (negative laparoscopy). In another 25 patients (28.4%), laparoscopic treatment was performed (therapeutic laparoscopy), including bleeding control in liver, colonic, gastric, and diaphragmatic repairs and intra-abdominal bleeding control. Laparotomy was avoided in a total of 70 (79.5%) patients. In 18 patients (20.5%), laparoscopy was converted to laparotomy. There was no mortality, and except one missed small bowel injury nor perioperative morbidity in patients undergoing laparoscopy. In the laparotomy group, major complications were seen in 7 patients. CONCLUSIONS: Laparoscopy is safe and efficient in the management of ASI and should be more frequently considered as a therapeutic tool.     

NT-proBNP与左心室舒张功能的相关性

目的 探讨血浆氨基末端前体脑钠肽 (NT-proBNP)与左心室舒张功能的关系.方法 选择超声心动图检查左心室射血分数≥45%的单纯舒张功能不全病人53例为研究组,左心室舒张功能正常34例为对照组,应用电化学发光法检测血浆NT-proBNP水平,左心导管检测左心室舒张功能,分析NT-proBNP水平与左心室舒张功能的相关性.结果 研究组NT-proBNP水平高于对照组,差异有显著性(t=77.237,P<0.001).左心室舒张末期压(AUC 0.82)是诊断左心室舒张功能不全特异度最高的指标,但其敏感度较低(73%).NT-proBNP诊断左心室舒张功能不全的阴性预测因子为93%,并且与侵入性检查指标左心室舒张末期压相关(r=0.48,P<0.01).结论 血浆NT-proBN水平可以作为评价有呼吸困难症状病人左心舒张功能不全的客观指标.