Cellular basis of diabetic nephropathy: V. Endoglin expression levels and diabetic nephropathy risk in patients with Type 1 diabetes

Endoglin is an accessory receptor molecule that, in association with transforming growth factor β (TGF-β) family receptors Types I and II, binds TGF-β1, TGF-β3, activin A, bone morphogenetic protein (BMP)-2 and BMP-7, regulating TGF-β dependent cellular responses. Relevant to diabetic nephropathy, endoglin, expressed in vascular endothelial and smooth muscle cells, fibroblasts, and mesangial cells, negatively regulates extracellular matrix (ECM). The aim of this study was to evaluate endoglin expression in cultured skin fibroblasts from patients with Type 1 diabetes with and without diabetic nephropathy. Kidney and skin biopsies were performed in 125 Type 1 diabetic patients. The 20 with the fastest rate of mesangial expansion (estimated by electron microscopy) and proteinuria (“fast-track”) and the 20 with the slowest rate and normoalbuminuria (“slow-track”), along with 20 controls were studied. Endoglin mRNA expression was assessed by microarray and quantitative real-time polymerase chain reaction (QRT-PCR) and protein expression by Western blot. Age and sex distribution were similar among groups. Diabetes duration was similar (20±8 vs. 24±7 years), hemoglobin A1c lower (8.4±1.2% vs. 9.4±1.5%), and glomerular filtration rate higher (115±13 vs. 72±20 ml/min per 1.73 m²) in slow-track vs. fast-track patients. Microarray endoglin mRNA expression levels were higher in slow-track (1516.0±349.9) than fast-track (1211.0±274.9; P=.008) patients or controls (1223.1±422.9; P=.018). This was confirmed by QRT-PCR. Endoglin protein expression levels correlated with microarray (r=0.59; P=.044) and QRT-PCR (r=0.61; P=.034) endoglin mRNA expression. These studies are compatible with the hypothesis that slow-track Type 1 diabetic patients, strongly protected from diabetic nephropathy, have distinct cellular behaviors that may be associated with reduced ECM production.     

脂联素对巨噬细胞源性泡沫细胞内胆固醇含量的影响

目的 通过研究脂联素对细胞内胆固醇的影响,探讨其抗动脉粥样硬化作用的可能机制.方法 以人急性单核细胞白血病细胞株(THP-1细胞株)来源的泡沫细胞模型为研究对象,用不同浓度的脂联素(1 mg/L,5 mg/L和10 mg/L)进行体外干预.采用油红O观察泡沫细胞形成,用胆固醇氧化酶法检测细胞内胆固醇含量的变化,用荧光显微镜观察巨噬细胞对Dil标记的氧化低密度脂蛋白(Dil-Ox-LDL)的摄取率.结果 脂联素(1 mg/L,5 mg/L和10 mg/L)干预对巨噬细胞内总胆固醇(TC)无显著影响,却能促进胆固醇酯(CE)转化为游离胆固醇(FC),CE/TC比值明显降低(P<0.05);同时观察到脂联素(10 mg/L)干预后可抑制巨噬细胞对Dil-Ox-LDL的摄取.结论 脂联素能减少巨噬细胞对Ox-LDL的摄取和促进巨噬细胞内胆固醇酯的水解,这可能是脂联素抑制胆固醇沉着从而发挥抗动脉粥样硬化作用的机制之一.     

Arsenic trioxide downregulates the expression of annexin II in bone marrow cells from patients with acute myelogenous leukemia

Background Most patients with acute myelogenous leukemia （AML） suffer from disordered hemostasis. We have previously shown that annexin II （Ann II）, a high-affinity co-receptor for plasminogen/tissue plasminogen activator, plays a central role in primary hyperfibrinolysis in patients with acute promyelocytic leukemia （APL）. The expression of Ann II in cells from patients with major subtypes of AML and the effect of arsenic trioxide （As203） on Ann II expression in AML cells were investigated to determine whether As203-mediated downregulation of Ann II could restore hemostatic stability. Methods A total of 103 patients （48 females and 55 males; age, 19-58 years） were included. Plasma samples were collected before and after treatment as well as after complete remission. Ann II and plasminogen activation were measured in leukemic cells during treatment with 1 pmol/L As203. Results Before AS203 treatment, Ann II mRNA expression （real-time PCR） was the highest in M3 cells （P 〈0.05）, higher in M5 cells than that in M1, M2, M4, and M6 cells （P〈0.001）, and positively correlated with Ann II protein expression （flow cytometry） （r=0.752, P 〈0.01）. Exposure for up to 120 hours to As203 （1 μmol/L） had no significant effect on Ann II protein in M1 and M2 leukemic cells, but decreased Ann II protein expression twofold within 48 hours of exposure in M3 cells （P 〈0.05） and twofold within 96 hours in M5 cells （P 〈0.05）. The rate of plasmin generation was higher in APL, M5, and M4 cells than in M1, M2, and M6 cells. Conclusions As203 may reduce hyperfibrinolysis in AML by downregulation of Ann 11. Furthermore, As2O3 affects more than one form of AML （APL, M4 and M5）, suggesting its potential role in their management.     

Association between early glycemic management and diabetes complications in type 1 diabetes mellitus: A retrospective cohort study

AimsTo investigate the association between early HbA1c levels near diagnosis and future glycemic management, and analyzed risk factors of complications in people with T1DM.MethodsThis retrospective cohort study included 201 children and adolescents with T1DM. Patient data including sex, age at diagnosis, duration of disease, HbA1c levels, HbA1c variability during the follow-up period, and diabetes complications and comorbidities were collected.ResultsThe mean follow-up period of patients was 16.4 years. HbA1c levels in all three examined time points after diagnosis (first year, second year, and first two years) were significantly associated with recent HbA1c level, and second-year HbA1c was most closely correlated with recent HbA1c level. Elevated second-year HbA1c was a risk factor of diabetic ketoacidosis (DKA) and retinopathy, and increased variability of HbA1c was significantly related to various microvascular complications. When HbA1c is stratified into quartiles, the subjects of each quartile trend to stay within that quartile over the follow-up period.ConclusionsEarly HbA1c levels were closely associated with recent HbA1c levels and diabetes complications in patients with T1DMs. Strict glucose management after diagnosis and reducing variability of HbA1c may prevent future diabetes complications and comorbidities.     

老年人围手术期血压变化

随着人口老龄化,老年高血压患者的患病率逐年增加,需选择外科手术的老年高血压患者也逐渐增多。由于围手术期发生的生理性变化,血流动力学不稳定在围手术期很常见。尽管存在这种血流动力学改变频率及与其相关的潜在危害,特别是在老年人群中,但缺乏优化围手术期血压的指南。低血压与围手术期的不良结果有关,特别是肾损伤、心肌损伤和死亡率增加。个性化血压可能是老年人围手术期血压管理的关键。     

CDCA8通过调控增殖促进前列腺癌发生的作用机制研究

目的 探讨细胞分裂周期相关蛋白8（CDCA8）在前列腺癌（PCa）中的表达及作用机制。方法 通过生物信息学方法分析正常前列腺组织和PCa组织中CDCA8 mRNA水平差异。利用癌症基因组图谱（TCGA）数据库中RNA表达测序数据分析CDCA8表达相关的PCa患者无病生存期（DFS）。免疫组织化学方法检测根治性前列腺切除...     

Application of VPN Technique in the Construction of Public Health Information System

Summary： Data communication and sharing of five level network of Public Health Information System, i.e. nation, province, district （city）, county, and town, as far as to the countryside level were described, and how to apply the three solutions, i.e. Access VPN, Intranet VPN, and Extranet VPN of VPN technique to achieve the appropriation of the public network was also presented.     

我国7个地理区域哮喘急性发作住院患者季节性分布特征

目的 了解我国7个地理区域内哮喘急性发作住院患者的季节性分布特征。方法 对全国7个地理区域（东北、华北、华中、华东、华南、西北、西南）内的29家三甲医院2013－2014年间因哮喘急性发作住院的患者例数及同期该院呼吸内科总住院患者例数进行统计,逐月计算因哮喘急性发作住院患者占总住院患者的比例。对各个地区之间及每个地区不同月份之间哮喘急性发作患者的住院情况进行了统计学分析。结果 在研究的时间范围内,29家医院的呼吸科总住院患者为206 135例次,其中因哮喘急性发作住院患者为6 480例次,占同期总住院数的3.14%。不同地区间因哮喘急性发作住院人数占同期总住院人数的比例差异较大,东北地区比例最高（5.61%）,华东地区比例最低（1.97%）。不同地区之间哮喘患者住院比例的差异均有统计学意义（P<0.000 1）。多数地区因哮喘急性发作住院患者例数及比例都有两个高峰,分别位于2－4月及9－10月,东北、华东及华南地区的春季高峰更为显著,而华北及西南地区的秋季高峰更为明显,西北地区的高峰则位于冬季（12－1月）及夏季（6－8月）。东北、华北及西南地区各月份之间哮喘急性发作住院情况的差异有统计学意义（P<0.005）。结论 不同地区哮喘急性发作住院患者存在一定的季节波动性,多数地区存在春季及秋季两个高峰。