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1.
目的:探讨有氧康复运动对慢性心力衰竭(chronic cardiac failure,CHF)患者心室重构及血管内皮功能的影响。方法:78例CHF患者随机分为运动组(n=39)、对照组(n=39)。对照组给予常规内科药物治疗、日常活动能力训练,运动组在此基础上根据美国心脏病学会(American Heart Association,AHA)的《三阶段康复运动方案》进行有氧康复运动,共持续12周。比较两组治疗前后心脏结构和功能、血管内皮功能及生活质量的改善情况。结果:干预后,两组左室收缩末期内径(left ventricular end systolic diameter,LVESD)、左室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、明尼苏达心衰生活质量(Minnesota Living With Heart Failure,MLHF)评分、血清内皮素-1(Endothelin-1,ET-1)、血管紧张素Ⅱ(angiotensin Ⅱ,Ang Ⅱ)水平均明显减小,左室射血分数(left ventricular ejection fraction,LVEF)、6分钟步行试验(6 minute walking test,6MWT)、血清一氧化氮(nitric oxide,NO)、降钙素基因相关肽(calcitonin gene-related peptide,CGRP)水平均明显升高,且运动组LVESD、LVEDD、MLHF评分、血清ET-1、Ang Ⅱ水平明显低于对照组,LVEF、6MWT、血清NO、CGRP水平明显高于对照组,差异均有统计学意义(P0.05)。运动组干预期间心衰再入院率显著低于对照组,差异均有统计学意义(P0.05)。结论:有氧运动康复训练有助于改善CHF患者的血管内皮功能,延缓或逆转心室重构,提高生活质量,改善预后。  相似文献   
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3.
Myocardial infarction (MI) is a major condition causing heart failure (HF). After MI, the renin angiotensin system (RAS) and its signalling octapeptide angiotensin II (Ang II) interferes with cardiac injury/repair via the AT1 and AT2 receptors (AT1R, AT2R). Our study aimed at deciphering the mechanisms underlying the link between RAS and cellular components of the immune response relying on a rodent model of HF as well as HF patients. Flow cytometric analyses showed an increase in the expression of CD4+ AT2R+ cells in the rat heart and spleen post‐infarction, but a reduction in the peripheral blood. The latter was also observed in HF patients. The frequency of rat CD4+ AT2R+ T cells in circulating blood, post‐infarcted heart and spleen represented 3.8 ± 0.4%, 23.2 ± 2.7% and 22.6 ± 2.6% of the CD4+ cells. CD4+ AT2R+ T cells within blood CD4+ T cells were reduced from 2.6 ± 0.2% in healthy controls to 1.7 ± 0.4% in patients. Moreover, we characterized CD4+ AT2R+ T cells which expressed regulatory FoxP3, secreted interleukin‐10 and other inflammatory‐related cytokines. Furthermore, intramyocardial injection of MI‐induced splenic CD4+ AT2R+ T cells into recipient rats with MI led to reduced infarct size and improved cardiac performance. We defined CD4+ AT2R+ cells as a T cell subset improving heart function post‐MI corresponding with reduced infarction size in a rat MI‐model. Our results indicate CD4+ AT2R+ cells as a promising population for regenerative therapy, via myocardial transplantation, pharmacological AT2R activation or a combination thereof.  相似文献   
4.
Babu  A. M.  Kumar  Jalaja S.  Kumar  Vineet  Sarkar  A.  Datta  R. K. 《Mycopathologia》2003,156(3):207-213
Different mulberry genotypes show great variation in their resistance to the powdery mildew Phyllactinia corylea. Conidial germination and hyphal growth of P. corylea on the leaf surface of two susceptible mulberry genotypes, viz., Kanva 2 (K2) and Victory 1 (V1) varieties of Morus indica, and on two resistant species, viz., M. laevigata and M. serrata were studied by scanning electron microscopy. Conidial germination and growth of germ tubes were normal on all the leaves. The hyphae of P. coryleaidentify stomata on host leaves by their topographical features to produce the stomatopodia precisely over them. The holes and/or the grooves of stomata appear to provide the signals for the initiation of stomatopodia and similar structures are erratically developed over many local depressions or grooves on leaf surface. The abaxial surface of K2 leaf is smooth without prominent undulations of epidermal cell surface, and the stomata are flush with the leaf surface. Although successful penetration is also achieved on V1 leaf, its slightly undulated surface occasionally provides inaccurate tropic signals to the hyphae, inducing the development of stomatopodia away from the stomata. The leaf surfaces of M. laevigata and M. serrata are very rough with highly sculptured cuticle and abundant epidermal outgrowths. Stomata mostly remain sunken or hidden amidst the cuticular ornamentations and the hyphae fail to recognise the precise signals from them. As the surface architecture of the leaves provides many immense sources of tropic signals, stomatopodia are often produced over local depressions or grooves. In these cases the fungus fails to penetrate the leaf, does not develop beyond 24 h and penetration is rarely achieved on the leaves of the resistant plants. The study indicates that the stimulatory effect of the leaf surface topography of resistant varieties misleads the pathogen from successful penetration, thus contributing to the plant's resistance.This revised version was published online in October 2005 with corrections to the Cover Date.  相似文献   
5.
Epithelial cells lining the gastrointestinal tract and kidney have different abilities to facilitate paracellular and transcellular transport of water and solutes. In the kidney, the proximal tubule allows both transcellular and paracellular transport, while the collecting duct primarily facilitates transcellular transport. The claudins and E-cadherin are major structural and functional components regulating paracellular transport. In this study we present the novel finding that the transmembrane matrix receptors, integrins, play a role in regulating paracellular transport of renal proximal tubule cells. Deleting the integrin β1 subunit in these cells converts them from a “loose” epithelium, characterized by low expression of E-cadherin and claudin-7 and high expression of claudin-2, to a “tight” epithelium with increased E-cadherin and claudin-7 expression and decreased claudin-2 expression. This effect is mediated by the integrin β1 cytoplasmic tail and does not entail β1 heterodimerization with an α-subunit or its localization to the cell surface. In addition, we demonstrate that deleting the β1 subunit in the proximal tubule of the kidney results in a major urine-concentrating defect. Thus, the integrin β1 tail plays a key role in regulating the composition and function of tight and adherens junctions that define paracellular transport properties of terminally differentiated renal proximal tubule epithelial cells.  相似文献   
6.
心力衰竭(心衰)是临床最常见的危重疾病之一,其致死率不低于某些癌症。随着现代医学进展,年龄依赖性死亡率明显下降,冠脉事件显著减少,患者生存时间延长,心衰患病率较前增加。针对心衰的研究不断更新,心衰的病理生理机制日益趋向完善,不仅仅涉及先前众所周知的心肌损伤或者心脏前后负荷增加,更多因素先后被发现参与心衰的发生、发展,包括神经内分泌机制、炎症反应,内分泌信号系统和生化因素等。伴随心衰病理生理过程产生了一系列的生物标记物,某些生物标记物在协助临床医生诊疗心衰患者方面发挥重要作用。具体包括神经激素类生物(例如:脑钠肽、氨基末端-pro BNP、心房钠尿肽前体中段、肾上腺髓质素前体中段和嗜铬素A),炎症因子类生物标记物(例如:CRP、IL-6和ST2),内分泌生物标志物(例如:脂联素、抵抗素、瘦素和醛固酮),其他生物标记物(包括:肌钙蛋白I/T、乳糖凝集素-3、胱氨酸蛋白酶抑制剂C、生长分化因子-15和基质金属蛋白酶)。生物标记物凭借其高度敏感性及特异性,在心衰的诊断、危险分层及评估预后等方面发挥重要作用。本文就心衰生物标记物最新研究进展做一综述。  相似文献   
7.
目的:探讨心房钠尿钛ANP 在高血压心力衰竭发展过程中的变化和氨氯地平保护心肌细胞的作用。方法:对大鼠行腹主动 脉结扎术,术后随机选择40 只大鼠分为氨氯地平(中、高、低剂量)组以及模型组,另外选取10 只健康雄性SD 大鼠作为假手术 组。采用ELISA 方法检测各组血清ANP 浓度变化。结果:随着心功能不全加重,ANP 水平逐渐上升。氨氯地平用药组大鼠的心功 能改善明显优于模型组,ANP 明显降低,且随着氨氯地平用药量上升,心功能不断改善,ANP显著下降,P<0.05。结论:对血清 ANP浓度进行测定能够反映出高血压大鼠模型心室功能不全及充血性心力衰竭严重程度。而氨氯地平能够影响机体的ANP 分 泌对心肌细胞起到保护作用,从而有效抑制心室重构,延缓高血压心力衰竭疾病进展。  相似文献   
8.
目的:观察输尿管软镜下钬激光碎石术与经皮肾镜下钬激光碎石术治疗肾结石对患者肾功能影响。方法:选择本院于2012 年5 月-2015 年5 月收治的单发肾结石且结石直径均≤ 2 cm的患者180 例作为研究对象,根据配对分组法分为两组,每组90 例,A组采取输尿管软镜下钬激光碎石术治疗,B组采取经皮肾镜下钬激光碎石术治疗。分别于手术前后测定两组患者尿Kim-1 及血清NGAL、Cys-C水平,评估患者肾功能。结果:两组术前及术后6 h、12 h、24 h、72 h尿Kim-1 水平比较均无统计学差异(P>0. 05);A 组术后48 h尿Kim-1 水平显著低于B组(P<0.05)。两组术后6 h、12 h、24 h尿Kim-1 水平均高于术前(P<0.05)。两组术后 6 h、12 h、24 h、48 h、72 h血清NGAL水平均高于术前,P<0.05。两组患者术前2 h、术后6 h血清Cys-C 水平均无显著统计学差异 (P>0.05);术后12 h、24 h、48 h、72 h血清Cys-C 水平均A 组均高于B 组(P<0.05)。结论:输尿管软镜下钬激光碎石术与经皮肾镜 下钬激光碎石术治疗肾结石均对患者肾功能造成损伤,但输尿管软镜下钬激光碎石术对肾小球损伤更为严重,经皮肾镜下钬激 光碎石术对肾小管损伤较为严重,临床应注意。  相似文献   
9.

Background

The etiology of premature ovarian failure (POF) still remains undefined. Although the majority of clinical cases are idiopathic, there are possibilities of the underestimation of the most common etiologies, probably genetic causes. By reporting a case of POF with a partial Xp duplication and Xq deletion in spite of a cytogenetically 46,XX normal karyotype, we look forward that the genetic cause of POF will be investigated more methodically.

Methods

We performed a basic and clinical study at a university hospital-affiliated fertility center. The study population was a POF patient and her family. Cytogenetic analysis, FMR1 gene analysis, multiplex ligation-dependent probe amplification (MLPA), fluorescent in situ hybridization (FISH), and oligonucleotide-array based comparative genomic hybridization (array CGH) were performed.

Results

In spite of normal cytogenetic analysis in the proband and her mother and younger sister, FMR1 gene was not detected in the proband and her younger sister. In Southern blot analysis, the mother showed a normal female band pattern, but the proband and her younger sister showed no 5.2 kb methylated band. The abnormal X chromosome of the proband and her sister was generated from the recombination of an inverted X chromosome of the mother during maternal meiosis, and the karyotype of the proband was 46,XX,rec(X)dup(Xp)inv(X)(p22.1q27.3).

Conclusion

Array CGH followed by FISH allowed precise characterization of the der(X) chromosome and the initial karyotype of the proband had been changed to 46,XX,rec(X)dup(Xp)inv(X)(p22.3q27.3)mat.arr Xp22.33p22.31(216519–8923527)x3,Xq27.3q28(144986425–154881514)x1. This study suggests that further genetic investigation may be needed in the cases of POF with a cytogenetically 46,XX normal karyotype to find out the cause and solution for these disease entities.  相似文献   
10.
目的:探讨肾康注射液对伴高同型半胱氨酸血症的高血压肾病患者心、肾功能的影响。方法:采用随机数字表法将76例高血压肾病伴高同型半胱氨酸血症患者随机分成研究组和对照组,每组各38例。两组均予以常规治疗措施,研究组则在上述基础上联合肾康注射液方案,持续治疗4周。观察比较两组治疗前后肾功能指标[血肌酐(SCr)、血尿素氮(BUN)、内生肌酐清除率(Ccr)]、肾损伤标志物[血清β2-微球蛋白(β2-MG)、血清胱抑素C(Cys-C)]、心功能指标[左室射血分数(LVEF)、心室舒张期末内径(LVIDd)、左心室收缩末期内径(LVIDs)]、炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]及动脉粥样硬化危险因子[同型半胱氨酸(Hcy)、内皮素]水平及不良反应的发生情况。结果:治疗4周后,两组患者部分肾功能指标(SCr、BUN)、肾损伤标志物(血清β2-MG、血清Cys-C)、部分心功能指标(LVIDd、LVIDs)、炎性因子(CRP、TNF-α、IL-6)及动脉粥样硬化危险因子(Hcy、内皮素)水平均较治疗前明显降低,且研究组以上指标均显著低于对照组(P均0.05);LVEF及Ccr水平则较治疗前明显提升,且研究组以上指标均显著高于对照组,差异均有统计学意义(P均0.05)。两组患者均无不良反应发生(P0.05)。结论:肾康注射液用于高血压肾病伴高同型半胱氨酸血症患者的临床治疗对延缓其肾损伤进程、改善患者心、肾功能及降低动脉粥样硬化形成风险等具有积极意义。  相似文献   
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