超敏C反应蛋白在冠心病中的临床应用

目的测定冠心病患者（CHD）血清超敏C反应蛋白（hs—CRP）水平，探讨其在CHD的发病及病情监测中的作用。方法经冠脉造影证实的CHD患者98例，采用胶乳增强免疫比浊法，定量检测血清中hs—CRP水平。并对其中43例CHD患者检测治疗后hs—CRP水平，并比较治疗前后hs—CRP的含量变化。结果CHD患者血清hs—CRP水平（8．25±6．38）较正常对照组（1．93±0．77）显著增高（P〈0．001）；其中心肌梗死（AMI）组（13．93±5．81）和不稳定型心绞痛（UAP）组（9．42±5．25）的hs—CRP水平明显高于稳定型心绞痛（sAP）组（3．57±3．10）（P〈0．01）；AMI组血清hs—CRP水平与UAP组差异也有显著性（P〈0．01）；除SAP组外，其中36例CHD患者治疗前后的hs—CRP水平差异亦有显著性（P〈0．05）。结论从SAP到AMI的过程中，hs—CRP水平有逐渐增加的趋势，说明hs—CRP水平与CHD的发生、发展和预后密切相关，可作为CHD的早期诊断和病情监测的指标，值得临床推广。     

Facilitation of Autonomous Phenotype Acquisition in Androgen-dependent Shionogi Carcinoma 115 Cells by Transfection of Androgen-induced Growth Factor Expression Vector

Androgen-induced growth factor (AIGF) is an autocrine growth factor for androgen-dependent SC-3 cells, which is induced by androgen stimuli. To elucidate the mechanism of the progression from hormone-dependent to -independent tumor, we transfected an expression vector of cDNA encoding AIGF into SC-3 cells and established a stable transfectant (Al) expressing AIGF. Al cells showed enhanced DNA synthesis. This enhanced DNA synthesis was blocked by exposing the cells to AIGF autisense oligonucleotides, heparin, or suramin, indicating that enforced AIGF expression is responsible for the increase in DNA synthesis. However, Al cells did not grow in serum-free medium unless stimulated with androgen. Recloning from Al cells in semi-solid agar supplemented with fetal calf serum but without androgen quickly generated an autonomous subline that was able to grow rapidly in the serum-free medium irrespective of androgen stimulus. Mock-transfected SC-3 cells failed to form any colony under identical conditions. These results suggest that stable expression of AIGF alone is not sufficient for, but facilitates the conversion of SC-3 cells from androgen-dependent to -independent phenotype.     

The Effect of MCT Oil Supplement in Very Low Birth Weight Infants, with Evaluation by the 13C-Labeled MCT Breath Test

We studied the efficacy of medium-chain triglyceride (MCT) as an energy source in premature infants. Infants who were given 3 g/kg/day of MCT oil gained body weight better than the control group in spite of a smaller water intake. This is advantageous to premature infants who need water restriction due to patent ductus arteriosus (PDA), bronchopulmo nary dysplasia (BPD), etc. We also proved that MCT oil is rapidly absorbed and digested, by means of the ¹³C-trioctanoin breath test.     

基质金属蛋白酶-9对急性冠状动脉综合征患者近期预后的意义

目的探讨对急性冠状动脉综合征(ACS)患者基质金属蛋白酶-9(MMP-9)的表达及其短期预后意义。方法分别测定60例ACS患者入院时MMP-9水平,随诊3个月,并以测定30例稳定型心绞痛及30例健康成人MMP-9作对照。血浆MMP-9的测定采用夹心酶联免疫吸附测定法,以MMP-9>30 ng/ml为界值,追踪观察正常组与增高组心脏事件发生率。结果ACS组的MMP-9水平(30.33±14.00)ng/ml,较正常对照组(2.84±1.39)ng/ml高(P<0.01);较稳定型心绞痛组(2.72±0.98)ng/ml高(P<0.01),稳定型心绞痛组(2.72±0.98)ng/ml较正常对照组(2.84±1.39)ng/ml无差异(P>0.05);在60例ACS中,MMP-9升高37例,随诊期共发生心脏事件18例,较正常组高(P<0.01)。结论MMP-9与ACS发生有关;与ACS的短期预后也有关,可作为危险分层的指标之一。     

稳定整合靶向细胞周期蛋白E1基因RNA干涉载体的肝癌细胞系的建立

目的探讨经载体介导的RNA干涉法建立周期蛋白E1表达稳定抑制细胞系的可行性。方法将源自pSSC-9质粒的neo基因亚克隆至干涉载体pSilencer 1.0-U6以构建稳定干涉载体pSineo,再将其与合成的靶向周期蛋白E1基因特定的RNA干涉模板片段连接,重组载体经脂质体LipofectamineTM2000介导法转染肝癌细胞株BEL-7402;转染细胞经G418筛选,常规抽提G418抗性克隆细胞的基因组DNA并行PCR法鉴定外源导入载体的稳定整合情况。结果酶切及测序鉴定结果均表明,重组载体pSineo-cyc E1符合预期设计;PCR鉴定结果显示,稳定筛选出的6个克隆均整合有靶向周期蛋白E1基因的干涉载体。结论本研究建立了6个稳定整合有靶向细胞周期蛋白E1基因RNA干涉载体的肝癌细胞系,为肿瘤的癌基因靶向干涉治疗作了有益探索。     

Stable microbubble test for predicting the risk of respiratory distress syndrome: II. Prospective evaluation of the test on amniotic fluid and gastric aspirate

We determined prospectively if the stable microbubble (SM) test on gastric aspirate obtained at birth was as useful as that on amniotic fluid in predicting respiratory distress syndrome (RDS). One hundred and five paired samples of amniotic fluid obtained at delivery from 105 consecutive women with gestation of 35 weeks or less and gastric aspirates from their neonates obtained within 30 min of birth were studied. The SM test with the predefined cut-off value of less than 5 bubbles/mm² for amniotic fluid and less than 10 bubbles/mm² for gastric aspirate signified the risk of RDS with the positive predictive value of 100% and 96% and with the negative predictive value of 91% and 84%, respectively. We conclude that the SM test on both amniotic fluid and gastric aspirate obtained at birth is a rapid (<10 min), simple and reliable procedure for predicting neonates who will develop RDS. It may be used as a bedside test to define a population of neonates with surfactant deficiency in clinical trials of prophylactic surfactant therapy.     

Use of stable48Ca in the clinical measurement of intestinal calcium absorption

Summary Measurements of intestinal-calcium-absorption efficiency are fundamental for understanding calcium homeostasis in health and disease. Stable calcium isotopes are attractive tracers for such measurements, to avoid excessive radiation exposure to the subject and permit serial studies at short intervals. To realize this, we found it necessary to improve the sensitivity and precision of existing thermal neutron activation analyses for⁴⁸Ca. This report describes the details, sensitivity, precision, and accuracy of the improved method, and gives the results of studies in which intravenous⁴⁸Ca was used in conjunction with oral⁴⁷Ca to measure intestinal-calcium-absorption efficiency in patients.     

Assessment of cysteine synthesis in very low-birth weight neonates using a [13C6]glucose tracer

Background/Purpose

Cysteine is an amino acid necessary for the synthesis of all proteins, the antioxidant glutathione, and the neuromodulator taurine. Whether cysteine is an essential amino acid for premature neonates remains controversial. Using a [¹³C₆]glucose precursor in very-low-birth weight (VLBW) premature neonates, we measured the ¹³C content of cysteine in hepatically derived apolipoprotein (apo) B-100 and in the plasma to determine whether cysteine synthesis occurs and to relate minimum synthetic capacity to neonatal maturity.

Methods

Twelve VLBW premature neonates (birth weight, 907 ± 274 [SD] g; gestational age, 26.8 ± 2.4 weeks) were studied on day of life 7.8 ± 4.2 while on total parenteral nutrition (TPN) for 5.6 ± 4.5 days. A 4-hour intravenous infusion of [¹³C₆]glucose was administered. Blood samples were obtained immediately before and at the end of the infusion. Isotopic enrichment of cysteine was determined by gas chromatography/mass spectrometry. Analysis of variance, Student's t test, and linear regression were used for comparisons.

Results

The ¹³C isotope ratio of apo B-100-derived cysteine after the [¹³C₆]glucose infusion was significantly higher than baseline (18.57 ± 0.38 [SEM] vs 17.54 ± 0.25 mol%, P < .05). The ¹³C isotope ratio of plasma cysteine was also significantly higher than baseline (17.36 ± 0.25 vs 16.91 ± 0.16 mol%, P < .05). When expressed as a product/precursor ratio, the mole percent above baseline of [¹³C]apo B-100 cysteine/[¹³C₆]glucose correlated with birth weight (r = 0.74, P < .01).

Conclusions

Very low-birth weight neonates are capable of cysteine synthesis as evidenced by incorporation of ¹³C label into hepatically derived apo B-100 cysteine and plasma cysteine from a glucose precursor. The minimum capacity for intrahepatic cysteine synthesis appears to be directly proportional to the maturity of the neonate and may impact the capabilities of VLBW neonates to counteract oxidative stresses such as bronchopulmonary dysplasia and necrotizing enterocolitis.     

Highlighting the need for better patient care in stable angina: results of the international Angina Treatment Patterns (ATP) Survey in 7074 patients

BACKGROUND: Stable angina is a growing problem worldwide. Diagnostic methods and treatment regimens are established but data on actual practice are sparse and pre-date current guidance. OBJECTIVES: To compare diagnosis and treatment information with guideline recommendations, and to assess impact on quality of life. METHODS: This international epidemiological survey recruited patients through primary and secondary care clinicians from China, Czech Republic, Greece, Hungary, Portugal, Russia and Slovak Republic. Participants experienced at least one episode of stable angina within the previous four weeks. Outcomes included use of diagnostic techniques, pharmacological treatments, surgical intervention, secondary prevention and quality of life. RESULTS: The study included 7074 patients, average age 63.3 (sd 10.3). Diagnosis of angina was most frequently as a result of chest pains (87.4%) with confirmation by resting ECG in only 54.9%. Advice regarding risk factors was frequently given although secondary prevention was often ineffective with 41% of treated hypertensives lacking effective control. 97% of patients were taking at least one of the primary therapies for stable angina recommended by the guidelines with rates of individual therapies varying greatly across countries. Quality of life was lowest in countries with low rates of surgical intervention and poor observance of guidelines on pharmaceutical therapy. CONCLUSION: Results show that the management of patients with stable angina does not meet recommended standards, although the appropriateness of these guidelines in poorer countries needs further investigation. Overall, the survey indicates that improved medical care and risk factor management would enhance prognosis and improve quality of life.     

强化降脂对稳定型冠心病患者纤溶活性的影响

目的:探讨强化降脂治疗对稳定型冠心病患者纤溶活性的影响。方法:测定76例稳定型冠心病患者血脂水平、血浆组织型纤溶酶原激活物(t-PA)活性和纤溶酶原激活物抑制物-1(PAI-1)活性,随机分成常规剂量组(常规治疗 阿托伐他汀10 mg/d)和强化降脂组(常规治疗 阿托伐他汀40 mg/d)。治疗4周后复查血脂水平、t-PA活性和PAI-1活性。结果:常规剂量组治疗后血浆总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平显著下降(P<0.01),纤溶参数明显改善,表现为t-PA活性上升,PAI-1活性下降(P<0.01);强化降脂组治疗后TC、LDL-C水平显著下降(P<0.01),且较常规剂量组下降更低(P<0.05),纤溶参数改善较常规剂量组更有效(P<0.05)。结论:强化降脂治疗能更好地改善稳定型冠心病患者纤溶活性。