Insulin-like growth factor-1 as predictive factor of difficult laryngoscopy in patients with GH-producing pituitary adenoma: A pilot study

BackgroundGrowth hormone (GH)-producing pituitary tumors account for 10 to 15% of pituitary tumors. The hypersecretion of GH may induce changes in the airway anatomy through the activation of Insulin-like Growth factor 1(IGF-1) pathway. We sought investigate the role IGF-1 as a potential predictive factor of difficult laryngoscopy in patients with GH-producing pituitary adenoma.MethodsThis study was a single center retrospective study. We included 33 patients undergoing transsphenoidal resection of GH-producing pituitary. We recorded demographic data, el-Ganzouri risk index (EGRI) and modified Look-Evaluate-Mallampati-Obstruction-Neck mobility (mLEMON) score, and pituitary hormone plasma levels. We performed ordinal logistic regression to analyze the relationship between IGF-1 and EGRI, mLEMON, and Cormack-Lehane Grade score and a multiple logistic regression to test the capability of EGRI, mLEMON and IGF-1 levels to predict Cormack-Lehane score. Receiver operating curve (ROC), area under the curve (AUC), and cut-off value of IGF-1 were calculated.ResultsOnly 14 (42.8%) and 12 (36.36%) patients showed predictive factors of difficult intubation according to EGRI and mLEMON score, respectively. IGF-1 significantly correlated with Cormack-Lehane (p = 0.005879) but not with mLEMON and EGRI (p = 0.3080 and 0.4146, respectively). In multiple regression model IGF-1 correlated only with Cormack-Lehane grade (p = 0.0089). Area under ROC was 0.8571 and cut-off value of IGF-1 was 186.15 ng/ml.ConclusionHigher IGF-1 levels correlate with the probability of having a higher Cormack-Lehane score; classical bedside scores, such as mLEMON and EGRI, were not able to predict difficult laryngoscopy in our population.     

补骨脂素抗增生性瘢痕作用机制研究

目的探讨补骨脂素抗增生性瘢痕的作用机制。方法体外培养成纤维细胞,按随机数字表法分为正常组(培养正常成纤维细胞)、瘢痕组(培养增生性瘢痕成纤维细胞)、TGF-β1组(10 ng/ml TGF-β1处理增生性瘢痕成纤维细胞5 min^12 h)、Smurf2 RNA干扰组[Smad泛素化调节因子2(Smad ubiquitin regulatory factor2,Smurf2)siRNA转染增生性瘢痕成纤维细胞72 h]、补骨脂素组(10μmol/L补骨脂素处理增生性瘢痕成纤维细胞继续培养72 h)、补骨脂素+TGF-β1组(增生性瘢痕成纤维细胞加入补骨脂素培养72 h后加入TGF-β1培养6 h)。采用Western blot法检测Smurf2、α-平滑肌肌动蛋白(α-actin SMA,α-SMA)蛋白表达;RT-PCR法检测Ⅰ型胶原蛋白mRNA表达;ELISA法检测TGF-β1蛋白分泌。结果与正常组比较,瘢痕组Smurf2蛋白[(0.83±0.08)比(0.38±0.07)]表达增加(P<0.05);与瘢痕组比较,Smurf2 RNA干扰组TGF-β1[(2.2±0.18)比(4.2±0.47)]表达降低(P<0.05);TGF-β1组Smurf2[(0.71±0.06)比(0.42±0.04)]、α-SMA[(1.42±0.12)比(0.91±0.09)]蛋白表达增加(P<0.05),Ⅰ型胶原蛋白mRNA[(0.72±0.09)比(0.41±0.07)]表达增加(P<0.05);补骨脂素组Smurf2[(0.05±0.01)比(0.42±0.04)]、α-SMA[(0.71±0.07)比(0.91±0.09)]蛋白表达降低(P<0.05),Ⅰ型胶原蛋白mRNA表达[(0.12±0.04)比(0.41±0.07)]降低(P<0.05)。结论补骨脂素可能通过TGF-β1/Smurf2信号通路抑制α-SMA蛋白表达,从而降低Ⅰ型胶原蛋白表达,起到抑制瘢痕形成的作用。     

脑出血后IGF-1在脑组织中的表达及其对细胞凋亡的影响

目的研究胰岛素样生长因子-1（IGF-1）在实验性大鼠脑出血后脑组织中的表达厦其对细胞凋亡的影响。方法应用立体定向技术，将自体未抗凝血注入大鼠基底节区以制备脑出血模型；将动物分为正常对照组、实验组厦干预组，分别在不同时间断头取脑以制作标本，连续切片分别作IGF-1阳性细胞免疫组化染色及TUNEL染色。结果脑出血后2h血肿周围脑组织表达IGF-1，24h达表达高峰，7d时恢复正常；TUNEL染色阳性细胞于脑出血后8h开始出现，3d时达高峰，7d时仍有表达；给予外源性IGF-1后，凋亡细胞显著减少，与同时点实验组相比，差别有显著性。结论脑出血后IGF-1可抑制细胞凋亡的发生，从而减轻脑出血后继发性脑损伤。     

二甲双胍对多囊卵巢综合征患者胰岛素样生长因子-1的影响

目的探讨二甲双胍对多囊卵巢综合征（PCOS）患者血清胰岛素样生长因子-1（IGF-1）及胰岛素样生长因子结合蛋白-1（IGFBP-1）水平的影响及其作用机制，明确二甲双胍治疗的临床效果。方法2002年1—11月对山西医科大学第二医院24例PCOS患者给予二甲双胍500mg，一日3次，8～24周治疗，比较治疗前后血清IGF-1、IGFBP-1、空腹胰岛素及睾酮水平，并对月经恢复、排卵、妊娠情况进行分析。结果二甲双胍可降低血清空腹胰岛素及睾酮水平，能显著升高IGFBP-1水平，治疗前后血清IGF—1水平差异无显著性。单纯二甲双胍治疗后月经恢复率为41．67％（10／24）；自然排卵率为25．00％（6／24），自然妊娠率为12．50％（3／24）。二甲双胍加促排卵治疗共18个周期，排卵周期率66．67％（12／18），妊娠周期率为11．11％（2／18）。结论二甲双胍可以降低血清空腹胰岛素及睾酮水平，增高IGFBP-1水平，可以改善卵泡微环境，有助于月经恢复，提高促排卵和妊娠率．是治疗PCOS的重要手段。     

用逆转录—聚合酶链反应法对类胰岛素生长因子cDNA的扩增

逆转录-聚合酶链反应(RT-PCR)法是将PCR方法与逆转录法结合应用,可快速高效地扩增某一基因的全cDNA。类胰岛素生长因子-I(IGF-I)在人染色体中只有一个基因,全长超过45kb,并有内含子,其cDNA却只有几百个bp,为了表达得到IGF-I,本文利用RT-PCR方法,从胎肝提出的混合mRNA中,筛选并扩增了IGF-I的cDNA。经过分子克隆与测序,证明不需制备胎肝cDNA库,即可快速获得IGF-I的cDNA。     

Anabolic and catabolic hormonal response of elite runners to training at high altitude

A 2-week training period 2000 meters above sea level performed by 6 male elite Swedish runners influenced neither basal anabolic (total and non-sex hormone-binding globulin (SHBG)-bound testosterone (NST) and insulin-like growth factor-1 (IGF-1) nor catabolic (cortisol) hormones when comparing serum levels prior to and after the training camp. The anabolic vs catabolic hormone balance, expressed as the NST: cortisol ratio, also remained unchanged as well as SHBG and body mass. Thus, training at 2000 meters above sea level, often practised by elite runners to improve performance in competition at sea level, does not result in a catabolic situation after return to sea level, as measured by peripheral hormones. However, the adaptation to high altitude was associated with a slight (NS) decrease in testosterone as well as in anabolic vs catabolic balance as measured the third day at high altitude. Simultaneously, a decrease in subjective performance was claimed by the runners, but could not be shown by objective measurements. From day 3 to day 9 at high altitude, all runners claimed a subjective recuperation of performance. Total and non-SHBG-bound testosterone increased significantly from day 3 at high altitude to the first post-camp sea-level test. The results reflect the necessity of adaptation when travelling to races at different altitudes. The Swedish runners had significantly higher cortisol, total testosterone and NST levels compared with basal values of a group of 17 elite Kenyan runners living and training at high altitude. Since the NST cortisol and IGF-1 values were not lower, a catabolic state or malnutrition was not likely to be present. The results might reflect an adaptation to altitude or ethnic variations.     

用金标法快速测定血清中cTn-Ⅰ在急性心肌梗死诊断上的应用

为探讨急性心肌梗死和疑为心梗病人血中 c Tn I的敏感性和特异性 ,采用金标法对 5 2例就诊病人测定其血中 c Tn- 和酶学法测定 CK- MB两个指标 ,结果发现急性心肌梗死组病人血中的 c Tn- 敏感度高于 CK- MB,但二者无显著性差异 ;而疑为心梗病人血中的 c Tn- 敏感度高于 CK- MB且具有显著的特异性。c Tn- 的测定对急性心肌梗死病人的诊断和治疗具有特别重要的意义     

骨骼肌钝挫伤后愈合质量的肌电评价

目的 :观察大鼠骨骼肌钝挫伤后 ,不同干预方法对骨骼肌修复过程中肌电信号的影响 ,研究肌电图在骨骼肌损伤愈合过程中的评价作用。方法 :10 8只雄性SD大鼠 ,利用自制的重物坠落打击装置造成右侧腓肠肌钝挫伤。随机分成 3组 ,即胰岛素样生长因子 - 1(IGF - 1)组、中药组和自然愈合组 ,分别于损伤局部注射IGF - 1、黄芪丹参注射液、不作处理。于伤后第 2、5、7、10、14、2 1、2 8、35、5 6天观察并比较双侧腓肠肌的肌电图变化 ,记录纤颤电位和正尖波等自发活动 ,分析复合肌肉动作电位 (CMAP)并测量其潜伏期和波幅 ,观察伤后CMAP的变化。结果 :(1)各组大鼠均于伤后第 2～ 5天出现纤颤电位和正尖波 ,约至第 7～ 10天达到高峰 ,然后逐渐减少。以IGF - 1组最早消失 ,中药组次之。 (2 )各组大鼠的伤侧肌电图CMAP中的潜伏期逐渐缩短 ,波幅逐渐增高。以IGF - 1组最快 ,中药组次之 ,自然愈合组最慢。 (3)伤后第 8周 ,IGF - 1组和中药组大鼠损伤侧CMAP波幅接近正常 ,自然愈合组则显著低于其它两组。结论 :(1)肌电图检测证实 ,IGF - 1和黄芪丹参注射液均具有促进骨骼肌损伤愈合的作用 ,但以IGF - 1的作用更明显。 (2 )损伤肌肉局部肌电信号的变化 ,可以用来评价损伤骨骼肌的修复进程和愈合质量     

Hormonal responses to high- and moderate-intensity strength exercise

The hormonal responses of nine male, strength athletes to strength exercise were examined. The athletes performed one moderate- and one high-intensity strength exercise workout. In the high-intensity workout, the load was 100% of each subject's three-repetition maximum (3-RM) for squats and front squats, and 100% of each subject's six-repetition maximum (6-RM) for leg extensions. In the moderate-intensity workout, the load was 70% of the high-intensity protocol. Rest periods between sets were 4–6 min for both workouts. Blood samples were taken before, 30 min into, and every 15 min for the 1st h after exercise, and then 3, 7, 11, 22 and 33 h after exercise, thus allowing examination of both the acute and prolonged hormonal responses. Blood samples were analyzed for testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), cortisol, adrenocorticotrophic hormone (ACTH), growth hormone (GH), insulin-like growth factor (IGF-1), insulin, sex hormone binding globulin, creatine kinase, total protein, glucose and lactate. The acute responses of testosterone and cortisol were greater during the high-intensity protocol as compared to the moderate-intensity protocol. The cortisol response was associated with an increase in ACTH concentration. LH and FSH showed no response to either protocol. Acute GH responses were not different between protocols. There were great inter-individual differences in acute GH responses to both protocols. There were no significant differences between protocols with regard to prolonged responses for any hormone. In both trials, IGF-1 concentrations were significantly lower at 0800 hours the morning after exercise as compared to concentrations found at 0800 hours the morning before exercise. The mechanisms responsible for reducing IGF-1 concentration in these trials are unclear, and it is not known if this reduction observed 22 hours after exercise is of physiological significance. Accepted: 13 December 1999     

胰岛素样生长因子Ⅱ在肝细胞癌的免疫组化研究

以兔抗胰岛素样生长因子Ⅱ(IGF-2)的抗体,ABC法,对50例肝癌石蜡切片染色,结果:(1)正常肝有极微弱阳性,表明可分泌少量IGF-2;(2)癌旁肝27例,全部阳性,“++”者19例(70%),表明有大量IGF-2产生和存在;(3)50例肝癌,48例(96%)阳性,IGF-2呈胞浆弥散型分布,其中26例(52%)呈较强阳性(++),8例核内也有IGF-2,表明癌细胞能自己合成IGF-2为其恶性增殖创造条件,且不因分化程度之降低而有所减少;(4)IGF-2呈较强阳性(++)之细胞(包括小多角形肝细胞)既见于癌周肝,又见于慢性肝炎,表明胰岛素样生长因子Ⅱ直接和增殖而非与癌变相关。