脂代谢相关基因在低密度脂蛋白受体基因缺失幼龄小鼠肝脏中的表达分析

目的 探讨脂代谢相关基因在低密度脂蛋白受体(LDLR)基因缺失(LDLR-/-)小鼠肝脏中的表达特征及其与血脂紊乱和动脉粥样硬化早期病变的关系.方法 应用RT-PCR技术分析14、30、60和90天龄LDLR-/-与野生型(WT)小鼠靶基因表达差异,并进行血生化及主动脉形态学检测.结果 与同龄WT小鼠相比,LDLR-/-小鼠肝脏中载脂蛋白AⅣ、脂肪酸转运酶和肉碱棕榈酰转移酶Ⅰ的mRNA水平在14天龄时即显著下调(P＜0.05);30天龄时载脂蛋白A Ⅰ显著上调,载脂蛋白F则显著下调(P＜0.05);60天龄时肝X受体α显著升高(P＜0.05),酰基辅酶A氧化酶1在90天龄时显著下调(P＜0.05);载脂蛋白A Ⅴ、载脂蛋白E、过氧化物增殖物激活受体α和血管生成素样蛋白3差异无统计学意义(P＞0.05).血清总胆固醇、甘油三酯和低密度脂蛋白C含量从14天龄起均显著高于同龄WT小鼠(均P＜0.05),并随年龄增长持续升高.结论 上述脂代谢相关基因在幼龄小鼠即发生表达水平的改变,与血脂紊乱及主动脉病变发生过程呈正相关,说明其可能共同参与幼龄小鼠的脂质代谢紊乱,进而影响动脉内皮细胞功能改变乃至动脉粥样硬化早期病变的发生.     

Systemic transmigration of allosensitizing donor dendritic cells to host secondary lymphoid organs after rat liver transplantation

Donor dendritic cell (DC) migration and allosensitization in host secondary lymphoid organs after liver transplantation are ill defined. We used rat models to investigate graft-derived cells and intrahost allosensitization. Liver transplantation induced diffuse blood-borne migration of donor major histocompatibility class II antigen-positive (MHCII(+)) cells and MHCI(+) cells from the graft to host secondary lymphoid organs, not only the spleen, but also lymph nodes and Peyer's patches. The migrated MHCII(+) cells included DCs and some T cells and B cells. The DCs formed clusters with host BrdU(+) cells where they up-regulated CD86(+), and a CD8(+) T cell proliferative response originated within 24 hours after liver transplantation, demonstrating that these DCs can quickly mature and trigger direct allosensitization in host lymphoid organs. Transfer of allogeneic bone marrow cells also induced DC transmigration and a similar host response. In contrast, allogeneic thoracic duct lymph cells contained many fewer transmigrating DCs, and their transfer induced a comparable T cell response but significantly weaker CD8(+) T cell proliferation. Thus, there is a different outcome via the indirect pathway by host DCs that have captured donor alloantigens. Conclusion: The rat liver as well as bone marrow contains an immature DC population that can systemically transmigrate through blood vessel walls of the host secondary lymphoid organs, quickly mature, and induce diffuse intrahost CD8(+) T cell responses, which may promote graft rejection.     

有晶状体眼后房型人工晶状体植入术后人工晶状体位置异常原因的分析

目前近视发病率逐年上升。一直以来眼科医生通过准分子激光手术来矫正低、中度近视,然而此种手术对于角膜偏薄、圆锥角膜以及高度近视等部分患者的治疗存在局限性。1993年,瑞士STAAR公司生产了一种可植入式接触镜( ilplantable collaler lens, ICL),植入到后房睫状沟中,用来矫正屈光不正。经过设计的不断改进,ICL已经逐渐成为目前治疗中、高度近视的有效手术方式。虽然其安全性已被证实,但仍有文献报道, ICL植入术后人工晶状体的位置会发生偏位及旋转,导致视力下降,严重者产生继发性青光眼,前囊下白内障等并发症。我们针对ICL术后位置异常进行综述。     

Upregulated inflammatory associated factors and blood-retinal barrier changes in the retina of type 2 diabetes mellitus model

AIM: To examine the expression of high mobility group box-1 (HMGB-1) and intercellular adhesion molecule-1 (ICAM-1) in the retina and the hippocampal tissues; and further to evaluate the association of these two molecules with the alterations of blood-retinal barrier (BRB) and blood-brain barrier (BBB) in a rat model of type 2 diabetes. METHODS: The type-2 diabetes mellitus (DM) model was established with a high-fat and high-glucose diet combined with streptozotocin (STZ). Sixteen weeks after DM induction, morphological changes of retina and hippocampus were observed with hematoxylin-eosin staining, and alternations of BRB and BBB permeability were measured using Evans blue method. Levels of HMGB-1 and ICAM-1 in retina and hippocampus were detected by Western blot. Serum HMGB-1 levels were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: A significantly higher serum fasting blood glucose level in DM rats was observed 2wk after STZ injection (P＜0.01). The serum levels of fasting insulin, Insulin resistance homeostatic model assessment (IRHOMA), total cholesterol (TC), total triglycerides (TG) and low density lipoprotein cholesterol (LDL-C) in the DM rats significantly higher than those in the controls (all P＜0.01). HMGB-1 (0.96±0.03, P＜0.01) and ICAM-1 (0.76±0.12, P＜0.05) levels in the retina in the DM rats were significantly higher than those in the controls. HMGB-1 (0.83±0.13, P＜0.01) and ICAM-1 (1.15±0.08, P＜0.01) levels in the hippocampal tissues in the DM rats were also significantly higher than those in the controls. Sixteen weeks after induction of DM, the BRB permeability to albumin-bound Evans blue dye in the DM rats was significantly higher than that in the controls (P＜0.01). However, there was no difference of BBB permeability between the DM rats and controls. When compared to the controls, hematoxylin and eosin staining showed obvious irregularities in the DM rats. CONCLUSION: BRB permeability increases significantly in rats with type-2 DM, which may be associated with the up-regulated retinal expression of HMGB-1 and ICAM-1.     

Medical comorbidities at admission is predictive for 30-day in-hospital mortality in patients with acute myocardial infarction: analysis of 5161 cases

Background The present study investigated the prognostic value of medical comorbidities at admission for 30-day in-hospital mortality in patients with acute myocardial infarction (AMI). Methods A total of 5161 patients with AMI were admitted in Chinese PLA General Hospital between January 1, 1993 and December 31, 2007. Medical comorbidities including hypertension, diabetes mellitus, previous myocardial infarction, valvular heart disease, chronic obstructive pulmonary disease (COPD), renal insufficiency, previous stroke, atrial fibrillation and anemia, were identified at admission. The patients were divided into 4 groups based on the number of medical comorbidities at admission (0, 1, 2, and ≥ 3). Cox regression analysis was used to calculate relative risk (RR) and 95% confidence intervals (CI), with adjustment for age, sex, heart failure and percutaneous coronary intervention (PCI). Results The mean age of the studied population was 63.9 ± 13.6 years, and 80.1% of the patients were male. In 74.6% of the patients at least one comorbidity were identified. Hypertension (50.7%), diabetes mellitus (24.0%) and previous myocardial infarction (12%) were the leading common comorbidities at admission. The 30-day in-hospital mortality in patients with 0, 1, 2, and ≥ 3 comorbidities at admission (7.2%) was 4.9%, 7.2%, 11.1%, and 20.3%, respectively. The presence of 2 or more comorbidities was associated with higher 30-day in-hospital mortality compared with patients without comorbidity (RR: 1.41, 95% CI: 1.13-1.77, P = 0.003, and RR: 1.95, 95% CI: 1.59-2.39, P = 0.000, respectively). Conclusions Medical comorbidities were frequently found in patients with AMI. AMI patients with more comorbidities had a higher 30-day in-hospital mortality might be predictive of early poor outcome in patients with AMI.     

IL-8与糖尿病视网膜病变

糖尿病视网膜病变(diabetic retinopathy,DR)是最常见的糖尿病微血管并发症之一,然而其具体机制尚不清楚。现在炎症反应作为DR发病机制之一而被越来越多的学者关注,并提出DR是一种炎症性疾病。我们就炎症因子IL-8的特征及其在DR发生发展过程中的作用加以综述。     

晶状体在玻璃体切割术中对角膜内皮细胞保护作用的短期观察

目的:观察玻璃体切割术中保留晶状体对角膜内皮细胞的保护作用。方法:选择视网膜脱离合并增生性玻璃体视网膜病变接受了玻璃体切割术的32例32眼患者,其中14例因合并白内障或前段增生性玻璃体视网膜病变术中切割了晶状体,另外18例保留了晶状体。用角膜内皮显微镜测定术前和术后2wk内角膜内皮细胞,观察细胞的形态变化,并对细胞的4项定量指标进行统计学分析。结果:细胞形态学改变以术后无晶状体眼更明显。从细胞参数改变上看,术后4项定量指标有改变,与术前相比,有晶状体眼组差异无显著性(P>0.05);无晶状体眼组差异有显著性(P<0.05)。结论:玻璃体切割术时,晶状体的屏障功能减少了多因素对角膜内皮细胞的损害,保留晶状体可对角膜内皮细胞产生一定的保护作用。     

Oral health status in Sichuan Province:findings from the oral health survey of Sichuan, 2015–2016

To investigate oral health status in the residents of Sichuan Province, southwest China, a cross-sectional study was performed using the latest Oral Health Survey Basic Methods recommended by the World Health Organization. A multistage stratified random cluster-sampling method was used to enroll participants from the following three groups: children aged 3–5 years, adolescents aged 12 years, and people aged 65–74 years. In these three groups, the mean numbers of teeth that were affected by caries were 3.28, 0.86 and 5.13, respectively, resulting in a prevalence of 63.47%, 37.20%and 83.20%, respectively. Relative to the high rate of decayed teeth, the prevalence of fillings was very low in all age groups (0.97%, 7.24% and 5.43%, respectively). In the 12-year-old adolescent group, only 3.61%had good pit and fissure sealing. In addition, the rate of dental fluorosis was 24.80%, and the Community Fluorosis Index value was 0.39. In the elder group, the community periodontal index was 2.92. The prevalence in the elderly of having lost at least one tooth was 75.54%. Additionally, 4.44%of these participants were edentulous. The incidence of dental prosthesis was 51.75%, the proportion with a removable partial denture, a fixed denture, full dentures, dental implants and an informal fixed bridge was 21.59%, 11.45%, 4.64%, 0 and 16.67%, respectively. In this study, 8.2%of the elderly participants were affected by different types of oral mucosal lesions. Among such lesions, recurrent aphthous ulcers were most prevalent (2.69%) and oral lichen planuses were second (1.6%). The conclusion presented in this survey is that oral diseases, especially dental caries and periodontal disease, are frequent and common in Sichuan province, China. Moreover, the treatment rate is very low, and primary prevention and treatment options are therefore urgently needed in this population.     

无防腐剂的1%利多卡因对兔晶状体上皮细胞影响的组织病理学研究

目的探讨无防腐剂的1％利多卡因对兔晶状体上皮细胞（LECs）的影响,为寻求白内障术中清除上皮,预防囊膜混浊的有效药物提供实验依据。方法采集29只兔（58只眼）晶状体前囊膜及赤道部囊膜标本,分为3组,对照组囊膜不加药物处理、BSS组囊膜用BSS浸泡1min、利多卡因组囊膜用利多卡因浸泡1min,后行锥虫蓝-茜素红染色,显微镜照相,观察LECs活性同时对死亡细胞进行计数;并通过HE染色及透射电镜观察兔LECs的组织病理学改变。锥虫蓝．茜素红染色及死亡细胞计数15只兔（30只眼）：其中对照组5只兔（10只眼）,BSS组5只兔（10只眼）,利多卡因组5只兔（10只眼）;HE染色9只兔（18只眼）：其中对照组1只兔（2只眼）,BSS组4只兔（8只眼）,利多卡因组4只兔（8只眼）;透射电镜5只兔（10只眼）：其中对照组1只兔（2只眼）,BSS组2只兔（4只眼）,利多卡因组2只兔（4只眼）。结果对照组兔晶状体前囊膜上皮细胞死亡率（1．51±0．39）％,赤道部囊膜上皮细胞死亡率（1．52±0．32）％;BSS组兔晶状体前囊膜上皮细胞死亡率（1．78±0．50）％,赤道部囊膜上皮细胞死亡率（1．77±0．47）％;利多卡因组兔晶状体前囊膜上皮细胞死亡率（13．01±4．67）％,赤道部囊膜上皮细胞死亡率（9．59±3．35）％。经嵌套试验的方差分析,利多卡因组细胞死亡率明显高于对照组与BSS组（P〈0．05）。HE染色显示对照组与BSS组兔LECs仍贴附于囊膜上,未见明显病理改变。利多卡因组部分细胞与囊膜间产生空隙,并从囊膜上脱落,细胞空泡变性。透射电镜观察下对照组与BSS组细胞间及细胞与囊膜间连接完整。利多卡因组部分细胞间及细胞与囊膜间的连接被破坏,细胞脱落较多,排列松散。细胞膜塌陷,胞质内有大量的空泡形成,细胞结构被破坏。结论无防腐剂的1％利多卡因能松解兔LECs间及细胞与晶状体囊膜间的连接,并可导致LECs变性、死亡。     

新型双道阻抗血流图仪

本文提出的新型双道血流图可用于检测两道独立的心,脑,肢体等阻抗血流数据并给出分析报告,可对心,脑,肝,肾及肢体等器官进行血流分析,打印相应的报告,临床试验表明,该仪器在心功能健康普查,心脏血管疾病的辅助诊断方面给出较为客观,可比性好的评价指标,可报告特征点数值,因此还可用于临床研究。