贝尼地平对高血压病患者血浆降钙素基因相关肽水平的影响

目的　探讨钙离子拮抗剂贝尼地平对高血压病患者血浆降钙素基因相关肽 (CGRP)水平的影响。方法　 5 8例门诊高血压病患者接受贝尼地平 4～ 8mg/d治疗 8周 ,以 38例相匹配的健康者为对照 ,测定高血压病患者治疗前后和对照者的血浆CGRP水平。结果　高血压病患者的血浆CGRP水平较对照者明显降低 (最小值 :1 2 8比 39 95ng/L ;最大值 :4 3 72比 15 5 5 9ng/L ;P <0 0 0 1) ;高血压病患者经贝尼地平治疗 2周收缩压和舒张压明显降低 (P <0 0 5 ) ;之后维持治疗 8周血压稳定 ,血浆CGRP水平则较治疗前显著升高 (最小值 :2 84比 1 2 8ng/L ;最大值 :12 3 99比 4 3 72ng/L ;P<0 0 0 1)。结论　钙拮抗剂贝尼地平在降低血压的同时可明显升高高血压病患者血浆CGRP水平。     

清热理气冲剂对实验性胆汁反流性胃炎大鼠血浆内皮素和降钙素基因相关肽的影响

目的 探讨清热理气冲剂对实验性胆汁反流性胃炎（BRG）大鼠血浆内皮素（ET）和降钙素基因相关肽（CGRP）的影响。方法 60只大鼠随机分为A组（中药等效剂量组），B组（中药大剂量组），C组（西沙必利等效剂量组），D组（枸橼酸铋钾等效剂量组），E组（病理对照组）和F组（正常对照组）。除F组外，其余各组大鼠应用胆汁灌胃导致胃黏膜损害。2W后分别应用清热理气冲剂等效剂量、大剂量、西沙必利、枸橼酸铋钾处理。实验第4周观察胆汁反流性胃炎胃黏膜病理形态和应用放免法测定血浆ET和CGRP含量。结果 F组可见黏膜下层充血水肿，胃小凹增生，肠上皮化生，炎性细胞浸润等，而A组和B组胃黏膜组织形态显著改善。F组电镜观察到胃黏膜细胞问的紧密连接受损，线粒体肿胀，粗面内质网扩张，微绒毛变短或丢失，A组和B组的超微结构明显的改善。A组和B组血浆ET明显低于E组（P〈0．01）。A组和B组血浆CGRP明显高于E组（P〈0．01）。结论 清热理气冲剂可以减轻胃黏膜损伤，通过影响血浆ET和CGRP相关肽含量而达到治疗BRG目的。     

Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs

PURPOSE: To estimate how much the improvement in bone mass accounts for the reduction in risk of vertebral fracture that has been observed in randomized trials of antiresorptive treatments for osteoporosis. METHODS: After a systematic search, we conducted a meta-analysis of 12 trials to describe the relation between improvement in spine bone mineral density and reduction in risk of vertebral fracture in postmenopausal women. We also used logistic models to estimate the proportion of the reduction in risk of vertebral fracture observed with alendronate in the Fracture Intervention Trial that was due to improvement in bone mineral density. RESULTS: Across the 12 trials, a 1% improvement in spine bone mineral density was associated with a 0.03 decrease (95% confidence interval [CI]: 0.02 to 0.05) in the relative risk (RR) of vertebral fracture. The reductions in risk were greater than predicted from improvement in bone mineral density; for example, the model estimated that treatments predicted to reduce fracture risk by 20% (RR = 0.80), based on improvement in bone mineral density, actually reduce the risk of fracture by about 45% (RR = 0.55). In the Fracture Intervention Trial, improvement in spine bone mineral density explained 16% (95% CI: 11% to 27%) of the reduction in the risk of vertebral fracture with alendronate. CONCLUSION: Improvement in spine bone mineral density during treatment with antiresorptive drugs accounts for a predictable but small part of the observed reduction in the risk of vertebral fracture.     

Hypocalcemia response following calcitonin administration: Lack of correlation with osteoclast number determined after histoenzymologic identification in osteoprorosis

Summary The relationship between calcitonin-induced hypocalcemia and histomorphometric parameters of bone resorption was examined in iliac crest biopsies of 30 osteoporotic patients aged 55–86 years all of whom had received a single injection of 100 UI of salmon calcitonin. Number of osteoclasts and active resorption surfaces were determined after histoenzymologic staining based on osteoclastic tartrate resistant acid phosphatase content. No significant correlation could be demonstrated between the drop of hypocalcemia and the different histomorphometric parameters. It can be concluded that the calcitonin test is useless in osteoporosis.     

The value of bone scintigraphy in the follow-up of vertebral osteoporosis

Summary In an open study, we have assessed the bone/soft tissue uptake index in recent osteoporotic vertebral collapse using scintigraphy. The evolution of these cases was followed-up at 6 months in 22 patients treated with 100 IU of salmon calcitonin plus 500 mg of elemental calcium/10 days per month and in 18 patients treated with 500 mg of elemental calcium only on a daily basis. There were no index differences between groups prior to treatment. At six months, the group treated with calcitonin plus calcium showed a significant decrease from 10.2±6.4 to 3.2±1.1 (p<0.001), while the calcium only group did not show any significant changes (12.1±6.6 vs 9.2±4.6), considering that there were significant differences between groups (p<0.001). On a mid-term basis, these results have shown the values of the bone soft tissue index in the follow-up of osteoporotic vertebral collapse.     

Calcitonin gene-related peptide potentiates substance P-induced plasma extravasation in the rat trachea

Antidromic stimulation of vagal sensory nerves is known to produce plasma extravasation in the rat trachea. This neurogenic inflammation is thought to be mediated by substance P or other tachykinins released from sensory nerve endings. We sought to determine whether calcitonin gene-related peptide (CGRP), which is also released from sensory nerve endings, can potentiate substance P-induced plasma extravasation in the rat trachea. To accomplish this, we measured the amounts of Evans blue dye extravasated into the trachea after intravenous injections of substance P alone and combined with CGRP. We found that when substance P and CGRP were injected together, the amount of plasma extravasation produced in the trachea was substantially greater than the amount produced when substance P was injected alone. This potentiation was critically dependent on the dosage of CGRP and was not observed when relatively high dosages were used. We also found that CGRP had a potent hypotensive effect and speculate that reduced blood pressure may account for the lack of potentiation observed at the higher CGRP dosages. Based on these findings, we conclude that CGRP can potentiate substance P-induced plasma extravasation in the rat trachea and may therefore play a role in modulating neurogenic inflammation of the airways. Offprint requests to: J.J. Brokaw     

感觉神经肽在鼻后滴漏综合征性咳嗽中的作用

目的探讨感觉神经肽在鼻后滴漏综合征(PNDs)性咳嗽患者中的作用。方法收集2004年3月至2005年9月就诊于暨南大学附属第一医院呼吸内科的PNDs性咳嗽患者23例和PNDs患者16例,采用放射免疫法测定诱导痰上清液P物质(SP)、降钙素基因相关肽(CGRP)的质量浓度,另有8名健康成人为对照组。结果PNDs性咳嗽组SP(345.14±72.58)mg/L、CGRP(573.78±210.96)mg/L,与健康对照组[SP(168.14±56.97)mg/L、CGRP(227.69±70.84)mg/L]相比,差异具有显著性意义(P<0.01);与PNDs组[SP(270.98±36.25)mg/L、CGRP(362.13±73.67)mg/L]相比,差异亦具有显著性意义(P<0.05);PNDs组SP和CGRP亦高于对照组,差异具有显著性意义(P<0.05);PNDs性咳嗽组治疗后SP降至(261.09±37.04)mg/L、CGRP降至(335.73±55.07)mg/L,与治疗前相比,差异具有非常显著性意义(P<0.01),与对照组的差异也具有显著性意义(P<0.05)。结论感觉神经肽参与了PNDs的发病过程,同时可能是PNDs引起慢性咳嗽的机制。     

降钙素原在肺炎患者诊断中应用的临床意义

目的：探讨降钙素原（ PCT）测定在肺炎患者临床诊断的价值。方法将117例发热、胸痛、咳痰等疑为肺炎的患者作为观察对象,同时作胸腔X光、CT检查等影像学检查和PCT、超敏C反应蛋白（ CRP）、WBC计数等检测,以影像学检查结果为金标准,比较PCT、CRP、WBC计数在该诊断中的准确性、特异性、阴性及阳性预测值。结果117例患者中胸腔影像学检查肺部出现阳性结果59例,PCT增高88例,CRP增高66例,WBC增高60例;其敏感度和特异性分别为83．05％和44．83％,81．36％和77．59％,66．10％和74．14％。 PCT联合CRP应用敏感度和特异性分别为93．22％和41．38％,PCT联合WBC计数应用敏感度和特异性分别为89．83％和31．03％;按串联试验计算其敏感度和特异性分别67．60％和87．64％,54．9％和85．73％。把PCT阳性阈值提高至0．25 ng／ml以上时,敏感度和特异性分别33．90％和84．48％。结论 PCT、CRP、WBC计数是肺炎患者感染的诊断重要参考指标,PCT对感染诊断具有较强的敏感性,当把阳性阈值提高时特异性亦较高,联合应用可提高诊断的敏感度和特异性。     

骨力胶囊联合鲑降钙素治疗老年骨质疏松症的临床研究

目的探讨骨力胶囊联合鲑降钙素注射液治疗老年骨质疏松症的临床疗效。方法选取2016年3月—2018年3月三六三医院收治的骨质疏松症患者94例为研究对象,根据入院号的奇偶数分为对照组和治疗组,每组各47例。对照组皮下注射鲑降钙素注射液,50 IU/次,1次/d;治疗组在对照组治疗的基础上口服骨力胶囊,0.9 g/次,3次/d。两组均治疗8周。观察两组的临床疗效,比较两组的骨密度(BMD)、骨代谢指标、视觉模拟评分法(VAS)评分、Oswestry功能障碍指数问卷表(ODI)评分。结果治疗后,对照组和治疗组的总有效率分别为80.85%、95.74%,两组比较差异有统计学意义(P0.05)。治疗后,两组腰椎、股骨颈、股骨粗隆的BMD都明显增高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组腰椎、股骨颈、股骨粗隆的BMD明显高于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组血清β-胶原降解产物(β-CTX)、抗酒石酸酸性磷酸酶(TRACP)、骨碱性磷酸酶(BNALP)水平均显著下降,骨钙素(BGP)、25-羟维生素D[25-(OH)D]水平均显著增加,同组治疗前后比较差异有统计学意义(P0.05);且治疗组血清骨代谢指标水平明显优于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组VAS评分、ODI评分均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗后治疗组VAS评分、ODI评分明显低于对照组,两组比较差异有统计学意义(P0.05)。结论骨力胶囊联合鲑降钙素注射液治疗老年骨质疏松症具有较好的临床疗效,可缓解疼痛,增加BMD,改善骨代谢指标,具有一定的临床推广应用价值。     

Calcitonin receptor-stimulated migration of prostate cancer cells is mediated by urokinase receptor-integrin signaling

Abundance of calcitonin (CT) and calcitonin receptor (CTR) mRNA in primary prostate tumors positively correlates with tumor grade, and exogenously added CT increases the invasion of prostate cancer cell lines. We examined acute and chronic actions of CT on migration of highly metastatic PC-3M cells and poorly invasive LNCaP cells on several extracellular matrices in a spheroid disaggregation/migration assay. While PC-3M spheroids displayed maximum disaggregation/migration on vitronectin (VN), LNCaP spheroids preferred collagen but also migrated significantly on VN. Up-regulation of CT significantly enhanced disaggregation/migration of PC-3M spheroids on VN, but not on fibronectin. In contrast, down-regulation of CT, CTR, protein kinase A or urokinase-type plasminogen activator receptor (uPAR) led to amelioration of PC-3M spheroid disaggregation/migration. CT selectively increased surface activity of αvβ3 or α6β5 integrins in PC-3M and LNCaP cell lines, respectively, and uPAR-integrin association. Finally, either CT or urokinase could completely restore migration of CT-knock-down PC-3M spheroids. But, only forced expression of urokinase receptor coupled with exogenous addition of urokinase restored migration of CTR-knock-down spheroids. These results support our hypothesis that up-regulation of CT biosynthesis and activation of CT–CTR axis in primary prostate tumors may have direct relevance in their progression to the metastatic phenotype.