甘肃汉、回族2型糖尿病患者PPARγ2基因Pro12Ala多态性分析

目的 分析甘肃汉族和回族2型糖尿病患者PPARγ2基因Pro12A1a多态性(PP、PA、AA).方法 应用聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)确定PPARγ2基因Pro12Ala多态性的基因型及等位基因频率,比较两民族间的差异.结果 两个民族中,Pro12Ala多态性在同民族中2型糖尿病和正常对照组之间差异不具有统计学意义,A等位基因的分布频率在两民族2型糖尿病组中大致相同,分别为4.17%,4.62%(x2=0.027,P=0.871),2型糖尿病组中基因型为PP者体重指数、空腹血糖、甘油三酯均高于XA( PA/AA)基因型,但差异无统计学意义(P＞0.05).结论 在本实验中的甘肃汉族和回族人群中PPA Rγ2基因Pro12 Ala多态性主要以PP型为主,该多态性可能与2型糖尿病发病无关联.     

Effect of Selective Inflow Occlusion on Hemodynamic Conditions during Laparoscopic Left HemihepatectomyEffect of Selective Inflow Occlusion on Hemodynamic Conditions during Laparoscopic Left Hemihepatectomy

Background/Aims: Selective inflow occlusion instead of portal triad clamping was used during laparoscopic left hemihepatectomy in our institution. This study observed its hemodynamic effects during operation. Methodology: Hemodynamic parameters including heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP), cardiac index (CI), systemic vascular resistance (SVR) and pulmonary vascular resistance (PVR) were collected at 6 time points: after induction, after insufflation with CO2, after patient in reverse Trendelenburg position, after left branch of hepatic artery was occluded, after left branch of portal vein was occluded and after desufflation with patient supine. Results: No severe perioperative cardiopulmonary complications were observed. Occlusion of left branch of hepatic artery brought no significant hemodynamic change. Occlusion of left branch of portal vein increased CVP and CI and decreased SVR. CO2 inflation caused HR, MAP and SVR to increase. The change to reverse Trendelenburg position caused CVP and PAP to decrease. When placed in the supine position with deflation, MAP, CVP, PAP, PCWP and CI went to a higher than base level. HR and SVR returned to base level. Conclusions: Using selective inflow occlusion in laparoscopic left hemihepatectomy caused few hemodynamic changes before and after occlusion in patients without cardiopulmonary diseases. However, the change of position and inflation or deflation caused significant changes.     

Left atrial area index predicts adverse cardiovascular events in patients with unstable angina pectoris

Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index (LAAI) has predictive value for prognosis in patients with unstable angina pectoris (UAP). This study was aimed to assess the association between LAAI and outcomes in UAP patients. Methods We enrolled a total of 391 in-hospital patients diagnosed as UAP. Clinical and echocardiographic data at baseline were collected. The patients were followed for the development of adverse cardiovascular (CV) events, including hospital readmission for angina pectoris, acute myocardial infarction (AMI), congestive heart failure (CHF), stroke and all-cause mortality. Results During a mean follow-up time of 26.3 ± 8.6 months, 98 adverse CV events occurred (84 hospital readmission for angina pectoris, four AMI, four CHF, one stroke and five all-cause mortality). In a multivariate Cox model, LAAI [OR: 1.140, 95% CI: 1.016–1.279, P = 0.026], diastolic blood pressure (OR: 0.976, 95% CI: 0.956–0.996, P = 0.020) and pulse pressure (OR: 1.020, 95% CI: 1.007–1.034, P = 0.004) were independent predictors for adverse CV events in UAP patients. Conclusions LAAI is a predictor of adverse CV events independent of clinical and other echocardiographic parameters in UAP patients.     

Visualization of melatonin's multiple mitochondrial levels of protection against mitochondrial Ca2+-mediated permeability transition and beyond in rat brain astrocytes

Abstract: Melatonin protects cells against various types of oxidative stress‐induced apoptosis due primarily to its ability to effectively scavenge pathological and disease condition‐augmented generation of mitochondrial reactive oxygen species (mROS). Once produced, mROS indiscriminately damage mitochondrial components and more importantly they crucially activate directly the mitochondrial permeability transition (MPT), one of the critical mechanisms for initiating post mitochondrial apoptotic signaling. Whether or not melatonin targets directly the MPT, however, remains inconclusive, particularly during oxidative stress. This study, thus, investigated this possibility of an ‘oxidation free Ca²⁺ stress’ in the presence of vitamin E after ionomycin exposure as a sole Ca²⁺‐mediated MPT in order to exclude melatonin’s primary antioxidative effects as well as Ca²⁺‐mediated oxidative stress. The studies were carried out using cultured rat brain astrocytes RBA‐1. With the application of laser scanning multiple fluorescence imaging microscopy, we visualized for the first time multiple mitochondrial protective effects provided by melatonin during Ca²⁺ stress. First, melatonin, due to its primary antioxidative actions, completely prevented mCa²⁺‐induced mROS formation during ionomycin exposure. Secondly, when melatonin^’s antioxidative effects were prevented due to the addition of vitamin E, melatonin significantly prevented mCa²⁺‐mediated MPT and apoptosis suggesting its direct targeting of the MPT. Surprisingly, in the presence of cyclosporin A, a MPT inhibitor, melatonin reduced further mCa²⁺‐mediated apoptosis during ionomycin exposure also suggesting its targeting beyond the MPT. As astrocytes are actively involve in regulating synaptic transmission and neurovascular coupling in the CNS, these multiple mitochondrial layers of protection provided by melatonin against mCa²⁺‐and/or mROS‐mediated apoptosis in astrocytes may be crucial for future therapeutic prevention and treatment of astrocyte‐mediated neurodegenerative diseases in the CNS.     

Impedance feedback control of microfluidic valves for reliable post processing combinatorial droplet injection

Droplet microfluidics has found use in many biological assay applications as a means of high-throughput sample processing. One of the challenges of the technology, however, is the ability to control and merge droplets on-demand as they flow through the microdevices. It is in the interest of developing lab-on-chip devices to be able to combinatorically program additive mixing steps for more complex multistep and multiplex assays. Existing technologies to merge droplets are either passive in nature or require highly predictable droplet movement for feedforward control, making them vulnerable to errors during high throughput operation. In this paper, we describe and demonstrate a microfluidic valve-based device for the purpose of combinatorial droplet injection at any stage in a multistep assay. Microfluidic valves are used to robustly control fluid flow, droplet generation, and droplet mixing in the device on-demand, while on-chip impedance measurements taken in real time are used as feedback to accurately time the droplet injections. The presented system is contrasted to attempts without feedback, and is shown to be 100% reliable over long durations. Additionally, content detection and discretionary injections are explored and successfully executed.     

术前纤维蛋白原水平对肝细胞癌微血管侵犯及预后的影响

目的 探讨术前血清纤维蛋白原(fibrinogen,FIB)水平与肝细胞癌(hepatocellular carcinoma,HCC)微血管侵犯(microvascular invasion,MVI)的关系及FIB对根治切除术后HCC预后的影响.方法 回顾性分析福建医科大学孟超肝胆医院2015年1月至2019年4月行根...     

发展老年医学科应对我区老龄化的探索

随着人口老龄化进程的加快,老年患者不断增加。他们往往患有多种慢性疾病,因此对医疗服务的需求也不断增加。面对加速而来的老年社会,利用有限的医疗资源为老年人提供高效的医疗服务,对于政府及公共卫生保障体系是一项严峻的挑战,也需要医务工作者做出巨大的探索和努力。本文介绍了上海市松江区乐都医院为了应对该区老龄化的现状,推广现代老年医学理念,实现区域内医疗资源的合理利用所做的工作,并探讨发现的问题和解决的方法。     

溶栓治疗对急性心肌梗塞患者早期心室晚电位的影响

本文评价溶栓治疗对急性心肌梗塞患者晚电位的影响。１８０例患者发病后５．９±３．４天描记晚电位。按溶栓与否分为：溶栓组５２例；非溶栓组１２８例。晚电位阳性发生率分别为１７．３％和３９．１％（Ｐ＜０．０５）；溶栓患者按冠状动脉再通间接指征分为再通组３１例，未再通组２１例，晚电位阳性发生率分别为６．５％和３３．３％（Ｐ＜０．０５）；冠状动脉造影１８例，按心肌梗塞溶栓治疗标准分为再通组１１例，未再通组７例，晚电位阳性发生率分别为９．１％和５７．１％（Ｐ＜０．０５），均有显著性差异。提示溶栓治疗可降低心肌梗塞晚电位阳性发生率，其作用机制与再灌注有关。     

Changes in corneal innervation and pain responses in fungal keratitis

AIM: To characterize changes in the cornea nerve and pain responses in fungal keratitis (FK). METHODS: A retrospective analysis of in vivo confocal microscopy images of 11 FK corneas was performed, and the results were compared with those for 11 normal corneas. Subbasal corneal nerves were analyzed for total nerve number, main nerve trunk number, branching patterns and tortuosity. C57BL/6 mice were infected with Aspergillus fumigatus. Disease severity was determined through clinical scoring and slit lamp photography. Corneas were harvested at 1, 3, 5, and 7d post infection (p.i.) and assessed for β III tubulin. Corneal mechanical sensitivity thresholds were detected by von Frey test. β-endorphin (β-EP) and μ receptor protein expression was detected through Western blotting. RESULTS: Total nerve number, main nerve trunk number, and nerve branching were significantly lower in FK patients than in controls, but tortuosity was not significantly different. In infected mice, subbasal nerve density decreased from 1d p.i., reaching a minimum at 5d p.i. Clinical scores rose at 1d p.i., peaked at 3d p.i., and decreased at 5d p.i. Mechanical sensitivity thresholds showed the same trends. β-EP and μ receptor protein expression increased after infection. CONCLUSION: Corneal nerve density is lower in FK patients and Aspergillus fumigatus-infected mice than in controls. Pain sensitivity decreases with postinfection corneal ulcer aggravation. β-EP and μ receptor proteins are both upregulated in infected mouse corneas.