他汀类药物早期干预对急性冠脉综合征患者血脂、高敏C反应蛋白和纤维蛋白原的影响

目的 比较他汀类药物和阿司匹林联合用药与单用阿司匹林对急性冠脉综合征患者血脂、高敏C反应蛋白及纤维蛋白原的影响。方法 所有患者均在急性冠脉综合征发病后72h内开始接受药物治疗，他汀组(40例)应用他汀类药物加阿司匹林治疗8周，对照组(16例)单用阿司匹林治疗，观察两组总胆固醇、低密度脂蛋白胆固醇、高敏C反应蛋白和纤维蛋白原水平的变化。结果 治疗8周后，他汀组各指标显著降低，面对照组仅高敏C反应蛋白水平显著下降。他汀类药物降低高敏C反应蛋白、纤维蛋白原的程度与其降脂作用无关。结论 他汀类药物与阿司匹林联合用药降低高敏C反应蛋白和纤维蛋白原的作用可能优于单用阿司匹林，并与其抗炎作用有关。     

脑梗死患者急性期血小板膜糖蛋白表达的研究

目的　探讨脑硬死患者急性期血小板膜P -选择素 (CD6 2p)的表达及其与临床神经功能缺损程度的关系。方法　用流式细胞术测定 41例急性期脑梗死患者血小板膜CD6 2 p的表达。 结果　轻、中、重型脑梗死患者CD6 2 p的表达分别为 (1.38± 0 .2 9) %、(3.15± 1.5 8) %、(10 .46± 5 .0 7) % ,与正常对照组 (1.5 6± 0 .17) %比 ,轻型脑梗死患者CD6 2p的表达无显著性差异 (P >0 .0 5 ) ,中、重型脑梗死患者CD6 2 p的表达显著升高 (P <0 .0 5和0 .0 1)。结论　脑梗死患者急性期血小板膜CD6 2 p的表达与临床神经功能缺损程度有关。     

Metabolic activation of fluoropyrrolidine dipeptidyl peptidase-IV inhibitors by rat liver microsomes.

The current study evaluated the potential for two dipeptidyl peptidase-IV (DPP-IV) inhibitor analogs (1S)-1-(trans-4-([(4-trifluoromethoxyphenyl)sulfonyl]amino)cyclohexyl)-2-[(3S)-3-fluoropyrrolidin-1-yl]-2-oxoethanaminium chloride and (1S)-1-(trans-4-([(2,4-difluorophenyl)sulfonyl]amino)cyclohexyl)-2-[(3S)-3-fluoropyrrolidin-1-yl]-2-oxoethanaminium chloride (MRL-A and MRL-B), containing a fluoropyrrolidine moiety in the structure, to undergo metabolic activation. The irreversible binding of these tritium-labeled compounds to rat liver microsomal protein was time- and NADPH-dependent and was attenuated by the addition of reduced glutathione (GSH) or N-acetylcysteine (NAC) to the incubation, indicating that chemically reactive intermediates were formed and trapped by these nucleophiles. Mass spectrometric analyses and further trapping experiments with semicarbazide indicated that the fluoropyrrolidine ring had undergone sequential oxidation and defluorination events resulting in the formation of GSH or NAC conjugates of the pyrrolidine moiety. The bioactivation of MRL-A was catalyzed primarily by rat recombinant CYP3A1 and CYP3A2. Pretreatment of rats with prototypic CYP3A1 and 3A2 inducers (pregnenolone-16alpha-carbonitrile and dexamethasone) enhanced the extent of bioactivation which, in turn, led to a higher degree of in vitro irreversible binding to microsomal proteins (5- and 9-fold increase, respectively). Herein, we describe studies that demonstrate that the fluoropyrrolidine ring is prone to metabolic activation and that GSH or NAC can trap the reactive intermediates to form adducts that provide insight into the mechanisms of bioactivation.     

Soybean allergen glycinin induced the destruction of the mechanical barrier function in IPEC-J2

Humans and animals suffer a health threat to soybean allergy. The impaired mechanism of the intestinal barrier by food/feed allergen glycinin has not been clear. The effects of epithelial metabolic activity, permeability, integrity, and the tight junction (TJ) expression induced by glycinin were conducted using porcine intestinal epithelial cells (IPEC-J2) model in this study. The results showed the decreased metabolic activity (R² = 0.964, p < 0.001) and the increased alkaline phosphatase activity (R² = 0.528, p = 0.002) linearly correlated with glycinin levels (0–4 mg/mL). The trans-epithelial electrical resistance values declined stimulated by 4 mg/mL glycinin treatment in a time-dependent manner (0, 6, 12, or 24 h, p = 0.018), and also descended after 12 or 24 h glycinin treatment in dose-dependence (0, 0.5, 1, 2, or 4 mg/mL, p < 0.001). The glycinin-induced TJ expression of claudin-3, occludin, and ZO-1 were reduced (p < 0.05).     

老年人脑出血后脑血流量改变的研究

目的研究老年人脑出血后脑血流量改变及影响因素。方法对４２例老年脑出血患者在发病１周内行单光子发射型计算机断层扫描（ＳＰＥＣＴ）、脑血流显像和ＣＴ扫描，部分进行动态观察。结果脑血流量下降范围１０例局限在病灶周围，３２例累及病灶以外区域，其中小脑失联络１１例，１～６个月复查仍见广泛的血流量下降，血流减少的范围及程度与出血部位、出血量密切有关。结论老年人脑出血后存在持久广泛的脑血流量下降。     

血管性血友病因子基因19内含子MspⅠ多态性与冠心病危险因素的关系

目的 :探讨血管性血友病因子 (vonWillebrandfactor ,vWF)基因 19内含子MspⅠ多态性与冠心病(CHD)危险因素的关系。方法 :应用聚合酶链反应 (PCR)技术结合MspⅠ酶切分析等 ,测定了 10 9例CHD患者和 10 4例健康对照者vWF基因 19内含子MspⅠ限制性片段长度多态性频率 ,同时应用酶联免疫吸附测定(ELISA)技术测定血浆vWF水平。结果 :①vWF基因 19内含子MspⅠ基因型与高血压间差异有统计学意义 ( P<0 .0 5 ) ,而与性别、年龄、糖尿病、高脂血症和吸烟等危险因素差异无统计学意义 (P >0 .0 5 )。②vWF基因 19内含子MspⅠ基因型在高危组和低危组的分布差异无统计学意义 (P >0 .0 5 )。③伴高血压患者中M-/M-基因型与M+/M+基因型和M+/M-基因型的血浆vWF水平之间无统计学意义 (P >0 .0 5 )。结论 :vWF基因 19内含子MspⅠ多态性可能与CHD的危险因素之一高血压有关。     

结合新型冠状病毒肺炎疫情议“三山医院”的建设要领

新型冠状病毒肺炎疫情引起全球关注,病毒的高度传染性致使疫情迅速蔓延和大规模暴发。在应对突发的迅速蔓延的疫情过程中,快速建设一个安全性能高的应急传染病专科医院,对于患者治疗、医护人员防护和疫情的控制十分重要。笔者结合“三山医院”建设的经验和温州医科大学附属第一医院应急传染病治疗中心改造的实际经验,系统地对医院选址、医院规划和设计、暖通系统、给排水系统、医用气体要求及医疗废物处置进行阐述,并对关键环节进行探讨。