血清Sclerostin、OPN、Klotho蛋白、BMP-7水平与维持性血液透析患者血管钙化的关系研究

目的:探讨血清骨硬化蛋白(Sclerostin)、骨桥蛋白(OPN)、Klotho蛋白、骨形态发生蛋白7(BMP-7)水平与维持性血液透析患者血管钙化的关系。方法:选取2018年4月~2020年4月期间我院收治的109例维持性血液透析患者,经CT检查患者的血管钙化情况分为钙化组(48例)和非钙化组(61例),另选同期在我院进行体检的健康志愿者50例为对照组,对各组血清Sclerostin、OPN、Klotho蛋白、BMP-7水平进行检测对比。分析维持性血液透析患者血管钙化的影响因素。结果:钙化组、非钙化组血清Sclerostin、OPN水平高于对照组且钙化组以上指标水平高于非钙化组(P<0.05),钙化组、非钙化组血清Klotho蛋白、BMP-7水平低于对照组且钙化组以上指标水平低于非钙化组(P<0.05)。经单因素分析显示,维持性血液透析患者血管钙化与血清Sclerostin、OPN、Klotho蛋白、BMP-7有关(P<0.05)。经多因素Logistic回归分析显示,血清Sclerostin、OPN、Klotho蛋白、BMP-7是维持性血液透析患者血管钙化发生的影响因素(P<0.05)。结论:维持性血液透析患者通常伴随着血清Sclerostin、OPN水平升高,Klotho蛋白、BMP-7水平降低,且血清Sclerostin、OPN、Klotho蛋白、BMP-7是其血管钙化的影响因素,临床工作中应结合以上因素对此类患者进行针对性干预,预防其血管钙化的发生。     

血清锌-α2-糖蛋白、骨硬化蛋白、胎球蛋白A水平与维持性血液透析患者冠状动脉钙化的关系及其诊断价值研究

目的:研究血清锌-α2-糖蛋白(ZAG)、骨硬化蛋白(SOST)及胎球蛋白A(FA)水平与维持性血液透析(MHD)患者冠状动脉钙化的关系及其诊断价值。方法:将2018年1月~2021年4月于我院接受MHD的203例患者纳入研究。将其按照冠状动脉钙化积分分作钙化组133例以及无钙化组70例。分析两组各项基线资料以及实验室指标水平的差异,并以多因素Logistic回归分析明确MHD患者冠状动脉钙化的影响因素。另外,通过受试者工作特征(ROC)曲线分析明确血清ZAG、SOST及FA诊断MHD患者冠状动脉钙化的效能。结果:钙化组年龄及血磷、SOST水平均高于无钙化组,而血清ZAG、FA水平均低于无钙化组(P<0.05)。经多因素Logistic回归分析可得:年龄、血磷以及血清SOST、ZAG、FA均是MHD患者冠状动脉钙化的影响因素(P<0.05)。经ROC曲线分析发现:血清ZAG、SOST及FA联合诊断MHD患者冠状动脉钙化的曲线下面积、灵敏度、特异度以及约登指数均高于上述三项指标单独诊断。结论:血清ZAG、SOST及FA均和MHD患者冠状动脉钙化密切相关,可作为辅助诊断MHD患者冠状动脉钙化的生物学标志物。     

SDF-1 在乳腺癌患者血清中表达水平及临床意义

目的:分析SDF-1在乳腺癌患者外周血中的表达水平,探讨其临床意义。方法:Elisa法检测乳腺癌患者术前及术后血清SDF-1水平,分析其与乳腺癌临床病理特征的关系。结果:乳腺癌患者术前(69例)血清SDF-1水平明显高于正常对照组(20例)(6406.7±1302.5 pg/m L vs 5217.4±1225.7 pg/m L),有明显统计学差异(P<0.01),发生远处转移的乳腺癌患者(11例)血清SDF-1水平明显高于未发生转移者(58例)(7656.4±784.1 pg/m L vs 6169.7±1364.6 pg/m L),差异具有明显统计学意义(P<0.01)。ER及Her-2表达阳性乳腺癌的患者SDF-1水平较ER及Her-2表达阴性者低,差异亦有统计学意义(P<0.05)。结论:SDF-1可能是预测乳腺癌发生及远处转移的重要标志物。     

血清BNP浓度变化监测对预测STEMI患者PCI术后预后的预测价值

目的:分析血清B型钠尿肽(BNP)浓度变化对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)术后预后的预测价值。方法:选取130例发病12 h内行PCI治疗的STEMI患者,通过荧光免疫法测定所有患者治疗前、发病24h、发病1周血清BNP水平,根据发病24 h血清BNP水平将患者分为A(≤100 pg/m L)、B(100~400 pg/m L)、C(400 pg/m L)三组,比较各组入院时Gensini评分、PCI术后1周左室射血分数(LVEF)、左心室舒张末期容积(LVEDV)、左心室壁运动积分指数(LVWMSI)及术后6个月预后(主要心血管不良事件)情况。结果:A组Gensini评分最低,B组居中,C组Gensini评分最高;C组入院时Gensini评分、CI术后1周LVWMSI、随访6个月再发心肌梗死、心力衰竭、心律失常发生率均显著高于A、B组,B组以上指标均明显高于A组(P0.05);Pearson相关性分析显示患者24 h血清BNP水平与LVWMSI呈显著正相关(r=0.728,P0.01)。结论:血清BNP水平可有效反映STEMI患者PCI术后心功能,对近期不良心血管事件有一定的预测价值。     

不同糖耐量人群血清BED锌指蛋白3 表达水平及其与代谢相关指标的关系

目的:探讨不同糖耐量人群血清BED锌指蛋白3(ZBED3)表达水平及其与代谢相关指标的关系。方法:选取2012年1月到2014年3月在我院就医的115例2型糖尿病(T2DM)患者、97例糖耐量异常(IGT)患者及糖耐量正常(NGT的109名健康体检或志愿者,测定其血清中ZBED3的水平,并分析其与相关的代谢指标的关系。结果:女性群体血清ZBED3水平显著高于男性群体(121.3±33.5 pg/m Lvs 113.9±32.9 pg/m L,P=0.02);超重组血清ZBED3水平显著高于非超重组(132.5±31.4 pg/m L vs 111.4±30.2pg/m L,P=0.00);T2DM组血清ZBED3水平显著高于IGT组和NGT组(143.5±31.2 pg/m L vs 123.7±26.4 pg/m L,97.1±20.3pg/m L,P=0.00)。血清ZBED3水平与体重指数、腰围/臀围比值、体脂百分比、舒张压、收缩压、甘油三酯、空腹胰岛素、空腹血糖及Homa-胰岛素抵抗指数呈正相关(P0.01),与高密度脂蛋白胆固醇成明显负相关(P0.01);且腰围/臀围比值、体脂百分比、舒张压、甘油三酯、糖化血红蛋白及Homa-胰岛素抵抗指数是影响血清ZBED3水平的独立相关因素。结论:T2DM、IGT患者及超重群体血清ZBED3水平明显上升,且与肥胖和T2DM的发生发展密切相关。     

老年营养风险指数联合血清铁蛋白水平对维持性血液透析患者腹主动脉钙化风险的预测价值

摘要 目的：探讨老年营养风险指数（GNRI）联合血清铁蛋白（SF）水平对维持性血液透析患者腹主动脉钙化（AAC）风险的预测价值。方法：选取2020年3月-2022年4月安徽省铜陵市人民医院收治的112例维持性血液透析患者,根据有无合并AAC分为钙化组（n=63）与未钙化组（n=49）,比较两组临床资料、GNRI、血清SF水平。根据AAC评分将钙化组分为轻度钙化组（n=24）、中度钙化组（n=21）与重度钙化组（n=18）,比较三组GNRI、血清SF水平。采用Pearson相关性分析法分析钙化患者GNRI、血清SF水平与AAC评分的相关性;采用多因素Logistic回归模型分析AAC发生的影响因素,采用受试者工作特征（ROC）曲线分析GNRI、血清SF对维持性血透患者发生AAC风险的预测价值。结果：钙化组年龄大于未钙化组,白蛋白水平及GNRI低于未钙化组,透析时间长于未钙化组,低密度脂蛋白胆固醇、血磷、全段甲状旁腺素（iPTH）、血清SF水平高于未钙化组（P＜0.05）。轻、中、重度钙化组GNRI依次下降,血清SF水平依次上升（P＜0.05）。Pearson相关性显示,GNRI与AAC评分呈负相关,SF水平与其呈正相关（P＜0.05）。多因素Logistic结果显示,透析时间增加、血磷、iPTH、血清SF水平上升,白蛋白水平下降与GNRI分值降低为AAC发生的危险因素（P＜0.05）。ROC曲线显示,GNRI对AAC预测的曲线下面积（AUC）为0.744,血清SF的AUC为0.769,两者联合检测的AUC为0.844,GNRI的灵敏度与特异度为58.72%、77.66%,SF的灵敏度与特异度为85.75%、73.51%,两者联合检测的灵敏度与特异度为84.10%、79.67%。结论：GNRI下降及血清SF水平上升为维持性血透患者发生AAC的危险因素,与钙化程度密切相关,两者联合检测作为预测患者发生AAC风险的有效指标具有更高价值。     

尿毒症血透患者血清脂联素和血脂的相关性研究

目的:探讨血液透析患者血清脂联素水平与其血脂之间的相关性。方法:维持性血液透析病人72例(实验组)及健康体检合格者20人(对照组),用酶联免疫吸附法测定实验组血液透析前、后及对照组血清脂联素(APN)浓度,血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)及低密度脂蛋白(LDL)的含量。结果:实验组血清APN水平显著高于对照组[(28.526±18.780) mg/L vs(9.278±3.712)mg/L,p<0.01],并且在血液透析后血清APN水平反而增高;多元回归分析表明实验组血清APN与甘油三酯(TG)等呈负相关,与高密度脂蛋白(HDL)呈正相关。结论:血液透析患者血清APN水平明显高于正常人,血清APN水平与甘油三酯等呈负相关,与高密度脂蛋白呈正相关。     

结核性脑膜炎患者TNF-α和IFN-γ水平变化及临床意义

目的:探讨结核性脑膜炎(TMB)患者血清、脑脊液中肿瘤坏死因子-α(TNF-α)和干扰素-γ(IFN-γ)水平变化及临床意义。方法:2013年4月-2015年4月期间,选择我院收治的TBM患者36例为TBM组,30例无感染症状患者为对照组,采用酶联免疫吸附试验(ELISA)法测定并比较两组对象血清、脑脊液TNF-α和IFN-γ水平,分析其与疾病进展的关系。结果:TBM组患者血清及脑脊液中TNF-α水平和IFN-γ分别为(64.29±6.19)pg/m L、(30.28±3.18)pg/m L、(121.34±21.31)pg/m L与(69.35±8.42)pg/m L均明显高于对照组(4.62±0.83)pg/m L、(3.18±0.64)pg/m L、(8.62±1.34)pg/m L与(8.18±1.29)pg/m L,差异存在统计学意义(P0.05);III期患者TNF-α、IFN-γ水平水平显著高于I期和II期,II期显著高于I期,差异均有统计学意义(P0.05);TBM患者血清、脑脊液中TNF-α水平与疾病分期存在正相关(r=0.673,r=0.621,P0.05),IFN-γ水平与疾病分期存在正相关(r=0.726,r=0.692,P0.05)。结论:TNF-α和IFN-γ参与TBM的发病过程,并与患者的病情相关;检测TBM患者血、脑脊液TNF-α和IFN-γ水平,有利于疾病的诊断和对患者预后的判断。     

肿瘤坏死因子样弱凋亡诱导因子对人肝星状细胞生物学行为的影响

目的:观察肿瘤坏死因子样弱凋亡诱导因子(TWEAK)对人肝星状细胞(HSCs)株LX-2增殖、细胞周期、细胞凋亡、迁移及粘附能力的影响。方法:用不同浓度TWEAK培养LX-2细胞24或48 h,采用CCK-8法检测TWEAK对LX-2细胞增殖的影响,流式细胞术检测TWEAK对LX-2细胞周期和凋亡的影响,Transwell小室检测TWEAK对LX-2细胞迁移能力的影响,Matrigel基质胶检测TWEAK对LX-2细胞的粘附能力的影响。结果:与对照组相比,40 ng/m L和100 ng/m L TWEAK都能使LX-2细胞的迁移能力增强(P0.05),且100 ng/m L较40 ng/m L作用更强(P0.01);100 ng/m L TWEAK能够明显抑制LX-2细胞的粘附能力(P0.0001);40 ng/m L、100 ng/m L TWEAK对LX-2细胞的增殖、周期及凋亡无明显影响(P0.05)。结论:TWEAK能够增强LX-2细胞迁移能力,抑制其粘附能力。     

维持性血液透析患者心理状态及相关因素调查

目的:探讨维持性血液透析患者心理状态及其相关因素。方法:对60例维持性血液透析患者应用焦虑自评量表(SAS)和抑郁自评量表(SDS)评定其心理状态,并对其影响因素:包括患者的年龄、性别、婚姻状况、学历、透析时间及家庭支持情况进行调查。结果:60例维持性血液透析患者焦虑、抑郁的发生率分别为63.33%、55.00%。年龄大小、透析时间、家庭支持水平与其焦虑、抑郁发生率之间有明显差别,存在统计学意义(p0.05)。结论:维持性血液透析患者焦虑、抑郁检出率较高,与患者的年龄(呈正相关r=0.629 p0.01;r=0.567 p0.01)、透析时间(呈负相关r=-0.496 p0.01;r=-0.474 p0.01)及家庭支持水平(呈负相关r=-0.584 p0.01;r=-0.498 p0.01)有关,在今后护理工作中应对透析年龄大,透析时间短及家庭支持水平差的患者高度重视其心理护理。     

动脉粥样硬化斑块钙化机制的研究进展

心血管疾病中动脉粥样硬化斑块的钙化是动脉粥样硬化的临床标志之一,主要发生在动脉血管的内膜.动脉粥样硬化斑块核心的钙化不会增加斑块的易损性,而粥样斑块纤维帽上的微钙化会加强纤维帽的周向应力,致使斑块的易损性增加.动脉粥样硬化斑块的钙化机制包括被动钙化和主动钙化,被动钙化受激素和局部信号的调节,主动钙化机制涉及复杂的细胞生命过程,基质囊泡、细胞凋亡、外泌体、氧化应激反应和细胞自噬等均参与了钙化过程.本文对动脉粥样硬化斑块的钙化机制的进展进行综述.     

大鼠动脉钙化诱导过程中炎症小体复合物分子的变化

目的:以SD大鼠动脉钙化为模型,研究钙化发生过程中炎症小体复合物分子的变化。方法:大鼠皮下注射维生素D3诱导动脉钙化,并用HE染色检测动脉钙化的发生,用半定量PCR测定钙化发展过程中细胞内NALP3炎症小体复合物核心蛋白NALP3、ASC和Caspase-1的mRNA水平变化。结果:随着动脉钙化的发展,细胞内NALP3、ASC和Caspase-1的mRNA表达水平逐步增加。结论:构建了大鼠动脉钙化模型,并且发现NALP3炎症小体复合物在动物钙化诱导过程中表达增加,为进一步研究动脉钙化的机制及筛选抗动脉硬化药物打下基础。     

Intracellular precipitation of hydroxyapatite mineral and implications for pathologic calcification

In contrast to physiologic biomineralization occurring in bones, teeth and otoconia in vertebrates, calcification of soft tissues occurs in many pathologic conditions. Although similarities have been noted between the two processes, and despite the important clinical consequences of ectopic calcification, the molecular mechanisms regulating ectopic calcification are poorly understood. Although calcification is mainly extracellular, intracellular calcification has been reported and might indeed contribute to pathologic calcification of soft tissues. To better understand the process of intracellular calcification as a potential origin for pathologic calcification, and to examine the role of proteoglycans in this process, we investigated a pattern of intracellular nucleation and growth of hydroxyapatite in Madin–Darby Canine Kidney (MDCK) epithelial cells using electron microscopy, secondary ion mass spectroscopy (NanoSIMS), cytochemical staining, immunolabeling and biochemical analysis. We report here that under mineralizing cell culture conditions where β-glycerophosphate (βGP) was added as an exogenous organic source of phosphate, βGP-cleaving alkaline phosphatase activity increased and hydroxyapatite crystals subsequently nucleated within intracellular, membrane-bounded compartments. The small, leucine-rich proteoglycan decorin was also upregulated and associated with mineral in these cultures. Such information provides insight into the mechanisms leading to pathologic calcification and describes a process whereby hydroxyapatite deposition in cells might lead to ectopic calcification.     

INCOMPLETENESS OF THE COCCOSPHERE AS A POSSIBLE STIMULUS FOR COCCOLITH FORMATION IN PLEUROCHRYSIS CARTERAE(PRYMNESIOPHYCEAE)1

Pleurochrysis carterae is a marine biflagellate that produces calcified structures called coccoliths. The coccoliths are formed inside the cells and released from the latter after formation. The light dependence of calcium incorporation in this species was studied using⁴⁵Ca as a tracer. Cells exposed to a repeating cycle of 16 h of light and 8 h of darkness incorporated calcium in extracellular coccoliths at a more or less constant rate throughout a cycle. The cells divided during the dark periods with a concomitant decrease in size. Their size increased during the light periods Coccolith formation in cells incubated in continuous darkness was greatly reduced and finally ceased. These cells did not divide and did not increase in size. Removal of extracellular coccoliths prior to the calcium incorporation experiments stimulated coccolith formation both in dark-incubated cells and in cells exposed to a repeating light-dark cycle. Cells in the stationary phase of growth ceased producing coccoliths. Calcification could be induced in these cells by removal of the extracellular coccoliths. Based on these findings we suggest that cells of Pleurochrysis carterae tend to produce a complete cover of coccoliths and that the available cell surface is a factor controlling coccolith formation.     

INCOMPLETENESS OF THE COCCOSPHERE AS A POSSIBLE STIMULUS FOR COCCOLITH FORMATION IN PLEUROCHRYSIS CARTERAE (PRYMNESIOPHYCEAE)1

Pleurochrysis carterae is a marine biflagellate that produces calcified structures called coccoliths. The coccoliths are formed inside the cells and released from the latter after formation. The light dependence of calcium incorporation in this species was studied using ⁴⁵Ca as a tracer. Cells exposed to a repeating cycle of 16 h of light and 8 h of darkness incorporated calcium in extracellular coccoliths at a more or less constant rate throughout a cycle. The cells divided during the dark periods with a concomitant decrease in size. Their size increased during the light periods. Coccolith formation in cells incubated in continuous darkness was greatly reduced and finally ceased. These cells did not divide and did not increase in size. Removal of extracellular coccoliths prior to the calcium incorporation experiments stimulated coccolith formation both in dark-incubated cells and in cells exposed to a repeating light-dark cycle. Cells in the stationary phase of growth ceased producing coccoliths. Calcification could be induced in these cells by removal of the extracellular coccoliths. Based on these findings we suggest that cells of Pleurochrysis carterae tend to produce a complete cover of coccoliths and that the available cell surface is a factor controlling coccolith formation.     

A Suggestion fob Prevention of Loose Sections in the Bodian Peotargol Method

Prolonged immersion in an aqueous medium such as the protargol bath in the original Bodian method for paraffin sections may increase any tendency for sections to separate from the slide during their subsequent reduction.     

Morphological and chemical characterization of mineral concretions in the freshwater bivalve Anodonta cygnea (Unionidae)

The freshwater mussel Anodonta cygnea is commonly used as a model organism for biomineralization studies, its peculiar morphofunctional properties also make it an excellent environmental biomonitor. The first detailed on the calcareous concretions from gill and mantle tissue, as well as fluids of the freshwater bivalve A. cygnea, supported by histological, scanning, spectrometry, and spectroscopy analyses. Through these analyses, the morphology, structure, and chemical characterization of these biomineral concretions were accomplished. The concretions represent a high percentage of the dry weight of these organisms. In gill tissue, it can reach up to 50% of dry weight prior to reproductive maturity. Analysis of elemental composition of the tissue concretions showed the presence of calcium and phosphate, as main components, associated with other residual elements like iron, manganese, magnesium, and zinc. Concretions are arranged in concentric alternated layers of organic and inorganic matrix. The shape and size of the concretions vary substantially, from very small, less than 1 μm diameter with very regular round structure, found mainly in the mantle tissue, to more than 50 μm length with irregular globular clusters, found predominantly in the gills. The microstructural organization is of a hydroxyapatite polymorphism in the mantle, in contrast to the gills, which exhibit irregular structure and carbonated hydroxyapatite polymorphism. These differences are supported by higher contents of dinitrogen pentoxide, magnesium, and iron in the mantle concretions, but higher contents of manganese and zinc in the gills. Furthermore, the results indicate that the mineral concretion formation in A. cygnea is a hemocytes reaction to particle or toxic invasions. A second relevant role, concerns the close involvement of these microspherules on the adult and larval shell calcification. J. Morphol. 276:65–76, 2015. © 2014 Wiley Periodicals, Inc.     

Tube construction in the watering pot shell Brechites vaginiferus (Bivalvia; Anomalodesmata; Clavagelloidea)

The bizarre watering pot shells of the clavagellid bivalve Brechites comprise a calcareous tube encrusted frequently with sand grains and other debris, the anterior end of which terminates in a convex perforated plate (the ‘watering pot’). It has not proved easy to understand how such extreme morphologies are produced. Previously published models have proposed that the tube and ‘watering pot’ are formed separately, outside the periostracum, and fuse later. Here we present the results of a detailed study of the structure and repair of the tubes of Brechites vaginiferus which suggest that these models are not correct. Critical observations include the fact that the external surface of the tube and ‘watering pot’ are covered by a thin organic film, on to the inner surface of which the highly organized aragonite crystals are secreted. There is no evidence of a suture between the tube and the ‘watering pot’ or that the periostracum of the juvenile shell passes through the wall of the tube. Live individuals of B. vaginiferus are able to repair substantial holes in the tube or ‘watering pot’ by laying down a new organic film followed by subsequent calcareous layers. Brechites vaginiferus displays Type C mantle fusion, with the result that the whole animal is encased by a continuous ring of mantle and periostracum, thereby making it possible to secrete a continuous ‘ring’ of shell material. On the basis of these observations we suggest that watering pot shells are not extra‐periostracal but are the product of simple modification of ‘normal’ shell‐secreting mechanisms.     

CO2 concentrations in perennially ice-covered lakes of Taylor Valley, Antarctica

Lakes in Taylor Valley, southern Victoria Land,Antarctica, are unusual in that they areperennially covered by a 3–5 m thick ice layer.Previous work on gas concentrations in theselakes has shown that the surface waters aresupersaturated with respect to O₂,N₂O, as well as the noble gases. Our datashow that the dissolved CO₂ (CO_2(aq))concentrations, calculated from pH andCO₂, can be highly undersaturatedat shallow depths of the lakes. CO₂partial pressure values (pCO₂) are as lowas 10^–4.3 atm and 10^–4.2 atm in theeast and west lobes of Lake Bonney,respectively, and 10^–3.8 atm in LakeHoare. CO_2(aq) depletion occurred only inthe uppermost part of the water column, inassociation with elevated primary productivity(PPR). The upward diffusion of CO_2(aq)from the aphotic zone, and the annual input ofCO₂ via glacial meltwater can notreplenish the amount of CO_2(aq) annuallylost to primary productivity in the uppermostmeters of the water column. Calcification is alimited source of CO_2(aq), since the lakesare undersaturated with respect to calcitethrough portions of the austral summer.Preliminary respiration rates have been used toobtain an annual inorganic carbon balance.Further down in the water column, at the sitesof the deep-water maximum in primary production(PPR_max), which in Lakes Bonney andFryxell is associated with nutrient gradients,CO_2(aq) is not undersaturated. A largeupward flux from CO₂-supersaturatedaphotic waters provides a surplus ofCO_2(aq) at the PPR_max. Lake Fryxell,unlike the other lakes, is supersaturated withCO_2(aq) throughout the entire water column.