正加速度（＋Gz）暴露对冠脉不同程度狭窄猪血浆CK-MB和IL-6变化的影响研究

目的：观察正加速度（＋Gz）暴露处理后不同冠脉狭窄程度猪的血浆肌酸激酶同工酶（CK-MB）和白介素-6（IL-6）水平的变化特点,探讨心脏的危害,评估飞行员的飞行。方法：（1）20头巴马小型猪,在胸腔镜直视下手术丝线永久性结扎左前降支近端建立轻度（狭窄程度20-49%）、中度（狭窄程度50-69%）和重度（狭窄程度≥70%）狭窄的冠状动脉狭窄模型;（2）各组小型猪进行＋Gz暴露,分别观察其最大＋Gz加速度耐受值;（3）各组小型猪分别在其最大＋Gz加速度暴露处理前后1 min留取静脉血和分离血浆,测定CK-MB及IL-6的含量。结果：（1）各组小型猪最大＋Gz加速度耐受值分别为：①正常对照组：＋8 Gz;②轻度狭窄组：＋8Gz;③中度狭窄组：＋6 Gz;④重度狭窄组：＋5 Gz;（2）最大耐受＋Gz加速度暴露对各组小型猪血浆CK-MB及IL-6的影响差异有统计学意义（P〈0.01）,同时,在分别经过最大耐受＋Gz加速度暴露处理后,冠脉中度和重度狭窄模型猪血浆CK-MB和IL-6的浓度较正常对照组均显著升高（P〈0.01）,轻度狭窄组则升高不明显（P〉0.05）。结论：（1）＋Gz暴露对冠脉不同程度狭窄小型猪血浆CK-MB和IL-6水平的影响不同,狭窄程度越重,影响越大。（2）轻度狭窄模型猪在＋Gz暴露下血浆CK-MB和IL-6的浓度改变与正常对照组相似,提示冠脉轻度狭窄的飞行员可以继续飞行。     

320排CT冠脉造影检查对冠状动脉斑块成分分析可行性初探

目的:研究320排CT冠脉造影对分析冠状动脉轻度及重度狭窄患者斑块成分的价值。方法:2011年4月-2012年5月间我院1132例(62±12岁,42%女性)冠心病患者行320排CT冠状动脉造影检查,依据美国心脏协会16分段标准,分析每一例患者每一节段血管狭窄程度及斑块性质,CT斑块分型如下:Ⅰ型为钙化斑块,Ⅱ型为钙化为主的混合斑块,Ⅲ型为非钙化为主的混合斑块,Ⅳ型为非钙化斑块。比较不同狭窄程度组斑块类型差别。结果:共363例为冠脉血管正常人群,冠状动脉狭窄患者共769例,其中管腔狭窄程度<50%的轻度人群为367例,重度狭窄组(≥50%)为402例。重度狭窄患者组冠脉血管混合斑块数量较多,而非钙化斑块相对较少(Ⅰ～Ⅳ型斑块所占比例分别为22%,,39%,21%,18%),轻度狭窄患者组各斑块所占比例分别为29%,29%,26%,16%(p=0.006)。结论:随着冠状动脉狭窄程度的不同,冠状动脉粥样硬化斑块的类型也不尽相同,重度狭窄人群组中混合斑块较多而非钙化斑块较少。320排CT冠脉造影可对冠状动脉斑块成分进行分析。     

经胸腔镜建立巴马小型猪冠状动脉狭窄模型

目的探讨一种高效、稳定的经胸腔镜构建不同程度冠状动脉狭窄动物模型的方法。方法 20头巴马小型猪,在胸腔镜直视下手术丝线永久性环扎左前降支近端,从而造成前降支不同程度的狭窄。术后进行定量冠状动脉造影检查评价狭窄程度。结果 20头小型猪中18头手术顺利完成,2头术中出现室颤,除颤成功后分别于术后8 h和48 h死亡。术后行定量冠状动脉造影显示7头小型猪狭窄程度不超过50%,6头狭窄程度在50%到70%,5头狭窄程度在70%以上,即时手术成功率100%,建模成功率90%。结论完全胸腔镜下应用丝线环扎法可成功地制作不同程度的冠脉狭窄动物模型。     

和肽素、正五聚蛋白3对稳定性冠心病患者冠脉狭窄程度的评估价值

该文评估了和肽素(CPP)、正五聚蛋白3(PTX3)、脑钠肽(BNP)、磷酸二酯酶9A(PDE9A)与稳定性冠心病患者冠脉狭窄程度的相关性。选取58例经冠脉造影检查证实为稳定性冠心病的患者,其中,冠脉狭窄≥70%组患者30例(I组),冠脉狭窄70%组患者28例(II组),两组病史情况无显著差异。采用ELISA法测定血浆CPP、PTX3、BNP、PDE9A浓度,运用二元Logistic回归分析CPP、PTX3、BNP、PDE9A与冠脉狭窄程度是否≥70%之间的相关性,通过ROC曲线分析CPP、PTX3、BNP、PDE9A对冠脉狭窄的预测价值。研究结果表明,I组患者血浆中CPP、PTX3的水平明显高于II组(P0.05),而I、II两组的BNP、PDE9A血浆水平无统计学差异(P0.05)。二元Logistic回归分析发现,血浆中CPP、PTX3的水平高低与冠脉狭窄程度是否达到70%具有相关性(P0.05)。ROC曲线分析表明,CPP(1.07 ng/m L)预测冠脉狭窄≥70%的敏感度为63.3%,特异性为64.3%;PTX3(20.56ng/m L)预测冠脉狭窄≥70%的敏感度为63.3%,特异性为67.9%。综上可得,血浆中CPP、PTX3的水平对稳定性冠心病患者冠脉狭窄是否≥70%具有一定评估价值;而血浆中PDE9A、BNP的水平与稳定性冠心病患者冠脉狭窄是否≥70%是否具有评估价值依据不足。     

2型糖尿病患者血浆chemerin水平与其冠脉病变程度的相关性分析

目的:探讨2型糖尿病患者血浆趋化素(chemerin)水平与冠脉病变程度的关系。方法:选取2011年1月~2012年2月我院收治的2型糖尿病(T2DM)患者92例,均行冠状动脉造影检查。按冠状动脉造影结果分为单纯2型糖尿病无冠状动脉病变组26例(DM0);合并单支冠状动脉病变组32例(DM1);合并双支以上病变组34例(DM2)。另选取正常健康行冠脉造影检查者25例作为正常对照组(NC)。采用酶联免疫吸附法检测各组入选者血浆chemerin水平,并分析其与冠脉病变程度的相关性。结果:T2DM及T2DM合并冠状动脉病变患者血浆chemerin水平与NC组对比均明显升高,并且与冠状动脉病变严重程度呈正相关(P0.05)。各组血浆Chemerin水平与BMI、HOMA-IR、TC、和APOB各指标间呈显著正相关(r分别为0.781、0.723、0.415、0.694,P均0.01)。结论:2型糖尿病患者冠状动脉病变的发生发展可能与血浆chemerin升高有关。     

冠心病患者外周血中miRNA-21的表达水平及其临床意义

目的:探讨微小RNA-21(miRNA-21)在冠心病患者及冠状动脉无病变者血浆中含量的差异及其临床意义。方法:采集冠心病患者(试验组,56例)及冠状动脉无病变者(对照组,10例)的血浆,根据诊断指南提及的症状、心电图、心肌酶、造影结果将冠心病分为心绞痛(39例)和急性心肌梗死(17例)两个亚组,提取总miRNA,运用荧光实时定量PCR(qRT-PCR)方法检测miRNA-21含量及分析miRNA-21在各组中的差异表达。测定CK-MB、c Tn I、BNP、冠脉Gensini积分、LVEF值、LV、HCY等,并分析miRNA-21与这些临床指标的相关性。结果:与对照组比较,冠心病患者miRNA-21表达差异均有统计学意义(P0.05);并且急性心肌梗死组较心绞痛组miRNA-21表达水平明显升高。AMI组和对照组CK、CK-MB、c Tn I、Genisis积分比较差异有统计学意义(P0.05)。相关分析表明:急性心肌梗死患者循环miRNA-21的表达量与CK、CK-MB、c Tn I呈正相关性,与BNP、冠脉Gensini积分、LVEF值、LV存在负相关性。结论:冠心病患者miRNA-21表达较对照组表达水平升高,急性心肌梗死亚组更为显著。miRNA-21可能为急性心肌梗死潜在的诊断学标记物,其与冠脉狭窄程度有关,miRNA-21可能对缺血灌注损伤的心肌具有保护作用。     

冠心病患者心率变异性与冠状动脉病变狭窄范围及严重程度的关系研究

目的:探讨冠心病患者心率变异性(HRV)与冠状动脉病变狭窄范围及严重程度的关系。方法:选取上海市第十人民医院2015年1月至2018年7月期间收治的冠心病患者220例,所有患者均行冠脉造影及24 h动态心电图检查。按狭窄范围分为单支狭窄组(n=68)、双支狭窄组(n=82)、三支狭窄组(n=70),按狭窄严重程度分为轻度组(狭窄≤50%,n=62),中度组(50%狭窄70%,n=66),重度组(狭窄≥70%,n=92),另选取51例同期于我院体检的健康志愿者作为对照组。记录冠心病患者与对照组HRV各项指标,比较不同冠脉病变狭窄范围患者、不同狭窄严重程度患者正常平均N-N间期(SDNN)、正常相邻每5minR-R间期均数标准差(SDANN)、正常相邻正常N-N间期的均方根(RMSSD)、正常相邻间期差值高于50 ms心搏数占总心搏数的百分比(pNN50)、低频(LF)、高频(HF)及低频/高频比值(LF/HF)。结果:冠心病患者与对照组RMSSD、pNN50、LF、HF比较差异无统计学意义(P0.05),冠心病患者SDNN、SDANN低于对照组,LF/HF值高于对照组(P0.05)。不同冠脉狭窄范围、不同冠脉病变狭窄严重程度患者pNN50、LF、HF整体比较无统计学差异(P0.05),随着冠脉狭窄范围的增加或狭窄病变严重程度的加重SDDN、SDANN、RMSSD逐渐降低,LF/HF值逐渐升高(P0.05)。结论:HRV是评估心脏自主功能的良好指标,该指标中SDDN、SDANN、RMSSD、LF/HF值可作为评估冠心病患者冠状动脉的狭窄程度和狭窄范围的良好指标,具有重要的临床指导意义。     

冠心病患者冠脉支架术后发生再狭窄的危险因素回归分析

目的:探讨冠心病患者冠脉支架手术后发生再狭窄的危险因素,为提高临床治疗效果和改善预后提供指导。方法:回顾性分析2014年1月至2015年12月我院收治的226例行冠脉支架手术的冠心病患者临床病历资料,采用SPSS21.0分析冠脉再狭窄的发生情况及危险因素。结果:51例冠心病患者冠脉支架术后发生冠脉再狭窄(22.57%)。单因素分析显示,不同吸烟史、糖尿病史、脂蛋白a(Lp(a))水平、空腹血糖、尿素氮(BUN)、总胆红素、术前病变狭窄程度、植入支架支数、长度以及直径组冠心病患者的冠脉再狭窄发生率比较,差异有统计学意义(P0.05)。多因素Logistic回归分析,吸烟史、糖尿病史、Lp(a)水平、术前病变狭窄程度、植入支架支数、长度是冠心病患者冠脉支架术后再狭窄发生的独立危险因素,OR分别为2.261、1.944、3.593、2.798、2.449、3.823,差异有统计学意义(P0.05),植入支架直径是冠脉再狭窄发生的保护因素,OR为0.261,差异有统计学意义(P0.05)。结论:冠脉植入支架的总长度、数量,术前病变的狭窄程度、Lp(a)水平、糖尿病以及吸烟是冠心病患者冠脉支架术后发生再狭窄的独立危险因素,临床应不断优化支架并根据再狭窄的危险因素采取针对性的防治措施。     

解放军第309 医院第一分院内科

目的:冠状动脉钙化在介入治疗中经常能碰到并且能影响治疗的效果。踝臂指数(ABI)是一种简单易行的无创检查,可作为判断下肢周围动脉疾病(PAD)的良好的无创指标,而且可以预测心血管事件。本课题主要探讨踝臂指数(ABI)对冠状动脉钙化病变的预测价值。方法:100例确诊为冠心病的患者,其中男性70例,女性30例,对所有患者测量ABI及常规生化检查,再行血管内超声虚拟组织学(IVUS-VH)测量冠脉钙化,将冠脉钙化分为三组,比较组间ABI差异,再分析ABI与冠状动脉钙化的相关性。结果:按照不同冠脉钙化分组ABI有显著性差异(P<0.05),ABI>1.3与冠状动脉钙化存在相关性。结论:ABI>1.3对冠状动脉钙化病变的严重程度有预测价值;ABI与冠状动脉钙化病变呈相关性,可作为对冠心病患者危险分层评估的一项指标。     

踝臂指数对冠状动脉钙化病变的预测价值

目的:冠状动脉钙化在介入治疗中经常能碰到并且能影响治疗的效果。踝臂指数(ABI)是一种简单易行的无创检查,可作为判断下肢周围动脉疾病(PAD)的良好的无创指标,而且可以预测心血管事件。本课题主要探讨踝臂指数(ABI)对冠状动脉钙化病变的预测价值。方法:100例确诊为冠心病的患者,其中男性70例,女性30例,对所有患者测量ABI及常规生化检查,再行血管内超声虚拟组织学(IVUS-VH)测量冠脉钙化,将冠脉钙化分为三组,比较组间ABI差异,再分析ABI与冠状动脉钙化的相关性。结果:按照不同冠脉钙化分组ABI有显著性差异(P0.05),ABI1.3与冠状动脉钙化存在相关性。结论:ABI1.3对冠状动脉钙化病变的严重程度有预测价值;ABI与冠状动脉钙化病变呈相关性,可作为对冠心病患者危险分层评估的一项指标。     

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.