树脂灌血液灌流在顽固性高血压患者血液透析中的应用

目的：探讨树脂灌血液灌流对血液透析顽固性高血压患者血压及肾素-血管紧张素．醛固酮系统的影响。方法：选择我院82例,均分为I组和II组各41例,I组患者采用金宝8LR聚酰胺膜透析器进行常规透析,II组患者在常规透析的基础上串联树脂血液灌流,检测两组患者治疗前和治疗后3个月血清肌酐、尿素氮变化情况,和患者体内肾素活性、血管紧张素II和醛固酮变化情况,并对血压变化值进行比较。结果：两组患者治疗后3个月血肌酐、血尿素氮均明显较治疗前降低,I组患者治疗后3个月收缩压和舒张压较治疗前均无明显变化,II组治疗后3个月收缩压和舒张压均较治疗前明显降低,I组治疗后3个月肾素、血管紧张素II和醛固酮较治疗前无明显差异,II组治疗后3个月肾素、血管紧张素II和醛固酮较治疗前均明显降低。结论：血液透析联合树脂吸附灌在保证有效清除患者体内代谢物质的同时角色较好的控制患者血压。     

肾素与动脉粥样硬化性肾动脉狭窄支架术预后相关性研究

目的:评价下腔静脉肾素活性与动脉粥样硬化性肾动脉狭窄支架植入术后血压及肾功能的相关性.方法:选取我院2007年至2011年49例单侧或者双侧动脉硬化性肾动脉狭窄(ARAS)患者(狭窄程度＞70％),成功进行血运重建术;记录患者术前动脉粥样硬化相关危险因素;测量并记录术前及术后患者肾素、血管紧张素、醛固酮、血压、抗血压药物数量、肌酐,并对患者血压及肌酐进行1、3、12月随访观察,评价肾素水平与支架术后血压及肾功能的相关性.结果:根据患者术前与术后下腔静脉肾素水平下降值分为＞3 ng/ml/h组和＜3 ng/ml/h组,平均随访12个月,观察到肾动脉支架术后患者血压、肾素、血管紧张素、醛固酮均有明显改善,并趋于稳定;两组肌酐肾小球滤过率存在明显差异,分别为第1月随访(52.1+ 17.7 ml/min和38.3+ 17.5 ml/min P＜0.05)第3月随访(53.1+ 21.6 ml/min和41.7+ 16.6 ml/min P＜0.05)第12月随访(51.7+ 19.0 ml/min和41.9±20.7 ml/min P＜0.05);肾素水平下降值＞3 ng/ml/h组较＜3 ng/mi/h组血压及肾功能改善较明显.结论:肾素水平与动脉粥样硬化性肾动脉狭窄支架术后血压及肾功能改善有相关性.     

肾素- 血管紧张素- 醛固酮系统与原发性高血压病的关系

目的:探讨血浆肾素-血管紧张素系统与原发性高血压病的关系。方法:采用病例-对照研究设计,入选125例原发性高血压病患者与60例血压正常健康体检者为对照组。采用放射免疫方法测定立位、卧位血浆肾素活性(PRA),醛固酮(ALD)浓度及血管紧张素Ⅱ(AngⅡ)浓度。结果:原发性高血压患者,立位、卧位血浆PRA均低于正常对照组(P<0.05),而ALD浓度及AngⅡ浓度均高于正常对照组(P<0.05)。根据高血压病1级、2级、3级分组,立位、卧位血浆PRA均依次降低(P<0.05);而ALD浓度及AngⅡ浓度依次升高(P<0.05)。结论:肾素-血管紧张素-醛固酮系统与原发性高血压病的发病关系密切,血浆PRA水平、AngⅡ及ALD浓度有望成为原发性高血压病分级的有效指标;降低原发性高血压患者AngⅡ及ALD量是治疗高血压病的关键,血浆AngII、ALD也有望成为评价原发性高血压病疗效的指标。     

乳酸菌发酵产品的降血压功能及其机制

1概述 血压是目前最为广泛的心血管疾病,据世界卫生组织（WHO）估计,全球患病人数已超过5亿.它是冠心病、脑卒死、心及肾功能衰竭的最主要发病因素,预防和治疗高血压将有助于降低心血管系统疾病的风险.高血压是由多方面因素引发的,如精神、神经、内分泌、遗传及血管紧张素转化酶（Angiotensin Ⅰ-converting enzyme,ACE）活性等,尤以ACE在血压调节过程中起关键作用.如图1所示,一方面,无活性的血管紧张素原在肾素的作用下转化为血管紧张素Ⅰ,血管紧张素Ⅰ在ACE的作用下转化为血管紧张素Ⅱ,血管紧张素Ⅱ能刺激血管收缩使血压升高,同时血管紧张素Ⅱ也能促使醛固酮分泌,直接对肾脏作用,引起纳储量和血容量增加也使血压升高.与此相反,缓激肽是降压物质,它能促使血管扩张和刺激扩血管物质前列腺素的合成增加,二者共同作用使血压下降.而在ACE的作用下,缓激肽分解成失活片断.如果人体内ACE活性过高,就会使血管紧张素Ⅱ生成增加,同时缓激肽被大大破坏,导致血压升高.     

重组脑钠肽对急性失代偿性心力衰竭患者炎症因子及肾素系统的影响

目的:探讨重组脑钠肽对急性失代偿性心力衰竭患者炎症因子及肾素系统的影响。方法:选择2014年7月~2016年7月于我院就诊的急性失代偿性心力衰竭患者160例,80例对照组行硝普钠治疗,80例实验组行重组脑钠肽治疗,观察两组治疗前后肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、脑钠肽(BNP),醛固酮、血管紧张素Ⅱ、血浆肾素活性,血流动力学变化及心功能情况。结果:治疗前,实验组TNF-α、hs-CRP、IL-6、BNP低于对照组,差异有统计学意义(P0.05)。实验组醛固酮、血管紧张素Ⅱ、血浆肾素活性低于对照组,差异有统计学意义(P0.05)。实验组血流动力学低于对照组(P0.05)。实验组心功能较对照组改善更明显(P0.05);实验组副反应少于对照组(P0.05)。结论:急性失代偿性心力衰竭患者应用重组脑钠肽治疗可降低患者炎症因子,改善肾素系统。     

复方α-酮酸联合血液透析和血液灌流治疗慢性肾衰竭的疗效及对钙磷代谢的影响

目的:研究复方α-酮酸联合血液透析和血液灌流治疗慢性肾衰竭(CRF)的临床疗效及对钙磷代谢的影响。方法:选择94例CRF患者为研究对象,按照随机数表法将患者分为联合组与对照组各47例。对照组采用血液透析、血液灌流进行治疗,联合组则在对照组基础之上联合使用复方α-酮酸治疗。比较治疗前及治疗6个月后两组患者肾功能指标[血清胱抑素C(Cys C)、血清肌酐(Scr)、血尿素氮(BUN)]及钙磷代谢(血钙、血磷)变化,并分析治疗6个月后两组患者疗效及治疗6个月内药物不良反应发生情况差异。结果:治疗6个月后,联合组治疗总有效率明显高于对照组(P0.05);两组患者Cys C、Scr、BUN及血磷水平均较治疗前显著降低,且联合组明显低于同一时间对照组(P0.05)。两组患者血钙水平均较治疗前显著升高,且联合组明显高于同一时间对照组(P0.05)。治疗6个月内,两组患者药物不良反应总发生率比较差异均无统计学意义(P0.05)。结论:复方α-酮酸联合血液透析和血液灌流治疗CRF的疗效显著,且能够改善肾功能与钙磷代谢,对患者疾病转归有利。     

肾素-血管紧张素系统

本文主要介绍肾素的生成部位、血管紧张素形成的可能途径、肾素分泌调节的四种假说、血管紧张素的作用及其与血压异常的关系。近年研究指出,失血时出现的大量血管收缩是由于血管紧张素Ⅱ的作用,提示血管紧张素拮抗剂有抗休克意义。血管紧张素Ⅱ除了对心血管系统的作用外,还有中枢性加压、嗜饮及刺激ADH 与 AGTH 分泌等作用。脑肾素-血管紧张素系统可能作为一种中枢性递质。晚近提出的“七肽假说”认为,血管紧张素Ⅲ是刺激醛固酮生成的“钥匙”,是当前兴趣的焦点。对心血管的作用似以血管紧张素Ⅱ为主,而对肾上腺皮质的作用则以血管紧张素Ⅲ更为重要。对恶性高血压及部分高肾素性血管收缩性高血压与特发性高血压,肾素-血管紧张素系统起着诱发与维持高血压的作用。因此,临床上对于不同类型的高血压,治疗措施应有所不同。在动物出血性低血压及休克的治疗中,认为转换酶抑制剂越早应用存活率越高,这为临床出血性休克的治疗提供了新的线索。     

CBP治疗重症急性胰腺炎患者的临床效果及其机制分析

探讨连续性血液净化(CBP)治疗重症急性胰腺炎的临床效果及其作用机制。选取在我院(2014年4月至2016年4月)收治的86例重症急性胰腺炎患者,其中43例患者(常规组)采用禁食禁水、胃肠减压、抗感染、解痉、调节水电解质等基础治疗,43例患者在常规组治疗基础上加用CBP治疗(观察组),对比两组患者的临床效果。结果显示,治疗前,观察组和对照组患者血清的IL-6、TNF-α、IL-10、PCT、IL-1β水平差异无统计学意义(p0.05);治疗后24 h、治疗后48 h、治疗后72 h,观察组患者的血清IL-6、TNF-α、IL-10、PCT、IL-1β水平均显著的低于对照组(p0.05);治疗后24 h、治疗后48 h、治疗后72 h,观察组患者的肾素、醛固酮、AngⅠ、AngⅡ、血清淀粉酶、尿淀治疗前,观察组和对照组患者肾素、醛固酮、AngⅠ、AngⅡ、血清淀粉酶、尿淀粉酶、血乳酸水平差异无统计学意义(p0.05);粉酶、血乳酸水平均显著的低于对照组(p0.05);治疗后,观察组患者治愈53.49%、有效44.19%、无效2.33%,常规组治愈32.56%、有效60.47%、无效6.98%,两组比较差异具有统计学意义(p0.05)。结果表明CBP治疗重症急性胰腺炎能减轻患者的炎症状态、调节肾素-血管紧张素-醛固酮系统,从而提高临床治疗效果。     

参芎葡萄糖注射液联合贝那普利治疗糖尿病肾病的疗效观察

目的:探讨参芎葡萄糖注射液联合贝那普利治疗糖尿病肾病(DN)的疗效及其治疗DN的机制。方法:将就诊的DN患者100例,按随机数字表法分为2组,每组50例,对照组给予贝那普利10 mg/d治疗,研究组给予参芎葡萄糖注射液联合贝那普利治疗,1次/d,14天为1个疗程,间隔1月开始第2疗程,共治疗3个疗程6个月,治疗前后检测2组肾功能、尿液指标等变化。结果:治疗后,2组血清肌酐(Scr)、尿素氮(BUN)水平较前无明显变化(P0.05),尿白蛋白排泄率(UAER)、尿白蛋白(UAlb)较治疗前均显著改善,差异有统计学意义(P0.05);研究组肾素(RA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)均低于自身治疗前及对照组治疗后,差异有统计学意义(P0.05);研究组血栓素A2(TXA2)高于对照组,而一氧化氮(NO)、前列环素I2(PGI2)低于对照组,差异有统计学意义(P0.05);2组治疗后丙二醛(MDA)、髓过氧化物酶(MPO)、超氧化物歧化酶(SOD)较治疗前均均有明显改善,差异有统计学意义(P0.05),然而2组比较差异无统计学意义(P0.05)。结论:贝那普利可改善DN患者氧化应激状态,加予参芎葡萄糖注射液可改善肾脏血流,缓解肾小球微循环障碍,这对改善肾功能有重要意义。     

怀菊花总黄酮对自发性高血压大鼠的降压作用及机制研究

研究怀菊花总黄酮对自发性高血压大鼠(SHR)的降压作用及其机制。将SHR随机分为模型组、怀菊花总黄酮高、中、低剂量组和依那普利阳性对照组。采用无创血压计测定血压及心率,采用放射免疫法测定血浆内皮素(ET)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、肾素活性(PRA)含量。结果表明怀菊花总黄酮能够降低SHR的血压(P0.01)、心率(P0.05)、血浆ET(P0.05)、AngⅡ(P0.01)、ALD(P0.01)、PRA(P0.01),其降压机制可能与改善内皮功能和抑制肾素-血管紧张素-醛固酮系统(RAAS)活性有关。     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.     

Enterovirus 71 3C proteolytically processes the histone H3 N-terminal tail during infection

Highlights
1. The N-terminal tail of histone H3 is specifically cleaved during EV71 infection.
2. Viral protease 3C is identified as a protease responsible for proteolytically processing the N-terminal H3 tail.
3. Our finding reveals a new epigenetic regulatory mechanism for Enterovirus 71 in virus-host interactions.     

Detection of EBV and HHV6 in the Brain Tissue of Patients with Rasmussen’s Encephalitis

Rasmussen’s encephalitis (RE) is a rare pediatric neurological disorder, and the exact etiology is not clear. Viral infection may be involved in the pathogenesis of RE, but conflicting results have reported. In this study, we evaluated the expression of both Epstein-Barr virus (EBV) and human herpes virus (HHV) 6 antigens in brain sections from 30 patients with RE and 16 control individuals by immunohistochemistry. In the RE group, EBV and HHV6 antigens were detected in 56.7% (17/30) and 50% (15/30) of individuals, respectively. In contrast, no detectable EBV and HHV6 antigen expression was found in brain tissues of the control group. The co-expression of EBV and HHV6 was detected in 20.0% (6/30) of individuals. In particular, a 4-year-old boy had a typical clinical course, including a medical history of viral encephalitis, intractable epilepsy, and hemispheric atrophy. The co-expression of EBV and HHV6 was detected in neurons and astrocytes in the brain tissue, accompanied by a high frequency of CD8⁺ T cells. Our results suggest that EBV and HHV6 infection and the activation of CD8⁺ T cells are involved in the pathogenesis of RE.     

Perinatal Vertical Transmission of Chikungunya Virus in Ruili,a Town on the Border between China and Myanmar

正Dear Editor,Chikungunya virus (CHIKV), an arbovirus in the family of Togaviridae, genus Alphavirus, is transmitted by the A.aegyptii or A. albopictus mosquito, and causes disease in humans characterized by fever, rash, and arthralgia (Silva and Dermody 2017; Suhrbier 2019). It was first reported in 1953 in Tanzania, and caused only a few outbreaks and sporadic cases in Africa and Asia in last century. However, in the epidemic in 2004, CHIKV acquired mutations that conferred enhanced transmission by the A. albopictus mosquito(Schuffenecker et al. 2006). Since then, it has successively caused outbreaks in Africa, the Indian Ocean, South East Asia, the South America, and Europe (Zeller et al. 2016).     

Development of a Novel Reverse Transcription Loop-Mediated Isothermal Amplification Method for Rapid Detection of SARS-CoV-2

In conclusion, the novel visual RT-LAMP assay is a simple, rapid, and sensitive approach for detection of SARS-CoV-2, and it is ready for application in primary care and community hospitals or health care centers, and even patients' own houses in response to the current SARS-CoV-2 epidemic because the assay does not require sophisticated equipment and skilled personnel. Furthermore, it is also ready to be used in fields for screening samples from wild animals and environments to facilitate the identification of potential intermediate hosts that mediate the cross-species transmission of SARS-CoV-2 from bats to humans.