精神分裂症患者甘露糖结合凝集素基因启动子区多态性及血清浓度的研究

目的:探讨精神分裂症患者甘露糖结合凝集素(MBL)的血清浓度和启动子区基因多态性的相关性及在患者免疫病理机制中的作用。方法:选取2018年6月至2018年12月在我院就诊的精神分裂患者为54例为观察组,另选取同时期本院健康体检中心志愿者56例为正常对照组,采用合酶链反应-序列特异性引物(PCR-SSP)技术分析MBL基因启动子区H/L(-550bp G/C)和X/Y(-221bp C/G)的多态性,酶联免疫吸附法(ELISA)检测血清MBL的浓度。结果:观察组血清MBL浓度(1367.218±1277.429)ng/mL低于正常对照组(1987.781±976.748)ng/mL,差异有统计学意义(P0.05)。观察组HY/HY基因型频率低于对照组(P0.05),HY/LY型频率高于对照组(P0.05)。观察组HY/HY基因型血清MBL浓度明显高于HY/LX、LY/LX型(P0.05);观察组MBL基因启动子区突变型纯合子的血清MBL水平均与对照组差异无统计学意义(P0.05),而MBL基因型杂合子的MBL水平则差异有统计学意义(P0.05)。结论:精神分裂症患者MBL水平低下与患者MBL基因启动子区各基因型的综合调控有关。MBL浓度低下是精神分裂症患者循环免疫复合物(CIC)滞留或清除障碍的分子机制之一。     

Mannose binding lectin and lung collectins interact with Toll-like receptor 4 and MD-2 by different mechanisms

Background

We have previously shown that lung collectins, surfactant protein A (SP-A) and surfactant protein D, interact with Toll-like receptor (TLR) 2, TLR4, or MD-2. Bindings of lung collectins to TLR2 and TLR4/MD-2 result in the alterations of signaling through these receptors, suggesting the immunomodulatory functions of lung collectins. Mannose binding lectin (MBL) is another collectin molecule which has structural homology to SP-A. The interaction between MBL and TLRs has not yet been determined.

Methods

We prepared recombinant MBL, and analyzed its bindings to recombinant soluble forms of TLR4 (sTLR4) and MD-2.

Results

MBL bound to sTLR4 and MD-2. The interactions were Ca²⁺-dependent and inhibited by mannose or monoclonal antibody against the carbohydrate-recognition domain of MBL. Treatment of sTLR4 or MD-2 by peptide N-glycosidase F significantly decreased the binding of MBL. SP-A bound to deglycosylated sTLR4, and this property did not change in chimeric molecules of SP-A/MBL in which Glu¹⁹⁵–Phe²²⁸ or Thr¹⁷⁴–Gly¹⁹⁴ of SP-A were replaced with the corresponding MBL sequences.

General Significance

These results suggested that MBL binds to TLR4 and MD-2 through the carbohydrate-recognition domain, and that oligosaccharide moieties of TLR4 and MD-2 are important for recognition by MBL. Since our previous studies indicated that lung collectins bind to the peptide portions of TLRs, MBL and lung collectins interact with TLRs by different mechanisms. These direct interactions between MBL and TLR4 or MD-2 suggest that MBL may modulate cellular responses by altering signals through TLRs.     

Increased plasma mannose binding lectin levels are associated with bronchiolitis obliterans after lung transplantation

Background

Long-term lung allograft survival is limited by bronchiolitis obliterans syndrome (BOS). Mannose binding lectin (MBL) belongs to the innate immune system, participates in complement activation, and may predispose to graft rejection. We investigated mannose binding (MBL) during cold ischemia and in tissue samples from explanted lungs with BOS, and assessed MBL and complement proteins in plasma post-lung transplantation relative to BOS staging.

Methods

MBL was detected by immunohistochemistry lung tissue at the time of cold ischemia and in samples with BOS. MBL was assayed in the peripheral blood of 66 lung transplant patients transplanted between 1990–2007.

Results

MBL localized to vasculature and basement membrane during cold ischemia and BOS. Patients further out post-lung transplant > 5 years (n = 33), had significantly lower levels of MBL in the blood compared to lung transplant patients < 5 years with BOS Op-3 (n = 17), 1738 ± 250 ng/ml vs 3198 ± 370 ng/ml, p = 0.027, and similar levels to lung transplant patients < 5 years with BOS 0 (n = 16), 1738 ± 250 ng/ml vs 1808 ± 345 ng/ml. MBL levels in all BOS 0 (n = 30) vs. all BOS Op-3 (n = 36) were 1378 ± 275 ng/ml vs. 2578 ± 390 ng/ml, p = 0.001, respectively. C3 plasma levels in BOS 0 (n = 30) vs. BOS Op-3 (n = 36) were 101 ± 19.8 mg/ml vs. 114 ± 25.2 mg/ml, p = 0.024, respectively.

Conclusions

MBL localizes within the lung during graft ischemia and BOS, higher levels of plasma MBL are associated with BOS Op-3 and < 5 years post-transplant, and higher level of plasma complement protein C3 was associated with BOS Op-3 clinical status. MBL may serve as a biomarker for poorer outcome post-lung transplantation.     

Low mannose-binding lectin function is associated with sepsis in adult patients

Mannose-binding lectin (MBL) is an innate immune system pattern recognition molecule that kills a wide range of pathogens via the lectin complement pathway. MBL deficiency is associated with severe infection but the best measure of this deficiency is undecided. We investigated the influence of MBL functional deficiency on the development of sepsis in 195 adult patients, 166 of whom had bloodstream infection and 35 had pneumonia. Results were compared with 236 blood donor controls. MBL function (C4b deposition) and levels were measured by enzyme-linked immunosorbent assay. Using receiver-operator characteristics of MBL function in healthy controls, we identified a level of <0.2 U microL(-1) as a highly discriminative marker of low MBL2 genotypes. Median MBL function was lower in sepsis patients (0.18 U microL(-1)) than in controls (0.48 U microL(-1), P<0.001). MBL functional deficiency was more common in sepsis patients than controls (P<0.001). MBL functional deficient patients had significantly higher sequential organ failure assessment (SOFA) scores and higher MBL function and levels were found in patients with SOFA scores predictive of good outcome. Deficiency of MBL function appears to be associated with bloodstream infection and the development of septic shock. High MBL levels may be protective against severe sepsis.     

Mannan-binding lectin (MBL) in women with tumours of the reproductive system

Mannan-binding lectin (MBL) is an important factor of innate immunity contributing to the clearance of microorganisms. Recently, an antitumourigenic role of MBL has been suggested. We investigated mbl2 genotypes, MBL concentrations, and MBL-MASP-2 complex activity in patients with ovarian cancer. The expression of both mbl2 and masp-2 genes were investigated in ovarian tissue sections. Additionally, samples from patients with other malignant and benign tumours of the reproductive tract were tested. A significantly higher incidence of MBL deficiency/insufficiency-associated genotypes was found among patients with malignant disease compared to age-matched controls. Unexpectedly, no differences in median MBL level or MBL-MASP-2 complex activity were found between the groups. This was partly a reflection of higher MBL concentrations and MBL-MASP-2 activity in cancer patients compared with healthy women carrying corresponding genotypes. MBL-specific mRNA expression was detected in several normal and malignant ovarian tissues, as well as in ovarian epithelial cell lines. Intracellular staining with MBL-specific antibodies demonstrated the presence of MBL in ovarian cell lines, and in normal as well as malignant ovarian tissue sections. In contrast, MASP-2-specific mRNA expression was detected only in the ovary tissues of patients with malignant disease. No significant changes in MBL concentration during 3 months of chemotherapy were noticed. MBL was detected in ascites and in the fluid of benign ovarian cysts. Our findings may reflect anti-tumourigenic activity of MBL protein which might suggest potential therapeutic application. However, it cannot be excluded that mbl-2 mutant alleles may be in linkage disequilibrium with an unidentified tumour susceptibility gene(s).     

Antimicrobial peptides are present in immune and host defense cells of the human respiratory and gastroinstestinal tracts

Previous studies have implicated antimicrobial peptides in the host defense of the mammalian intestinal and respiratory tract. The aim of the present study has been to characterize further the expression of these molecules in non-epithelial cells of the human pulmonary and digestive systems by detailed immunohistochemical analysis of the small and large bowel and of the large airways and lung parenchyma. Additionally, cells obtained from bronchoalveolar lavage were analyzed by fluorescent activated cell sorting and immunostaining of cytospin preparations. hBD-1, hBD-2, and LL-37 were detected in lymphocytes and macrophages in the large airways, lung parenchyma, duodenum, and colon. Lymphocytes positive for the peptides revealed a staining pattern and distribution that largely matched that of CD3-positive and CD8-positive T-cells. Macrophages with positive staining for the antimicrobial peptides also stained positively for CD68 and CD74. In view of the morphology of the LL-37-positive and hBD-2-positive mucosal lymphocytes, they are probably also B-cells. Thus, antimicrobial peptides of the defensin and cathelicidin families are present in a variety of non-epithelial cells of mucosal organs. These findings confirm that antimicrobial peptides have multiple functions in the biology of the mucosa of these organs. This work was supported by grants from the Deutsche Forschungsgemeinschaft (Ba 1641/5–1 and Ba 1641/6–1)     

High Mobility Group-Box 1 (HMGB1) levels are increased in amniotic fluid of women with intra-amniotic inflammation-determined preterm birth,and the source may be the damaged fetal membranes

BackgroundHigh Mobility Group Box-1 (HMGB1) is considered a prototype alarmin molecule. Upon its extracellular release, HMGB1 engages pattern recognition receptors and the Receptor for Advanced Glycation End-products (RAGE) followed by an outpouring of inflammatory cytokines, including interleukin (IL)-6.MethodsWe assayed the amniotic fluid (AF) levels of HMGB1 and IL-6 in 255 women that either had a normal pregnancy outcome or delivered preterm. Immunohistochemistry on fetal membranes was used for cellular localization and validation of immunoassay findings. HMGB1 also was analyzed in amniochorion tissue explants subjected to endotoxin.ResultsAF HMGB1 levels are not gestational age regulated but are increased in women with intra-amniotic inflammation and preterm birth. The likely source is the damaged amniochorion, as demonstrated by immunohistochemistry and explant experiments.ConclusionsOur research supports a role for HMGB1 in the inflammatory response leading to preterm birth. As a delayed phase cytokine, in utero exposure to elevated AF HMGB1 levels may have an impact on the newborn beyond the time of birth.     

妊娠高血压患者血清瘦素、Cys C及beta-HCG水平检测的临床意义

目的:研究妊娠高血压患者血清瘦素、胱抑素C(Cys C)以及人绒毛膜促性腺激素(β-HCG)水平检测的临床意义。方法:选取2014年4月到2015年4月我院收治的妊娠高血压患者90例(妊娠高血压组),另选同期正常妊娠者90例(正常妊娠组),健康体检非妊娠妇女90例(对照组),测量三组血清瘦素、Cys C以及β-HCG水平,并分析各指标的相关性。结果:妊娠高血压组和正常妊娠组血清瘦素、Cys C以及β-HCG水平均显著高于对照组,比较差异具有统计学意义(P0.05),妊娠高血压组血清瘦素、Cys C以及β-HCG水平均显著高于正常妊娠组,比较差异具有统计学意义(P0.05);妊娠高血压越严重血清瘦素、Cys C以及β-HCG水平越高;妊娠高血压患者血清瘦素与Cys C和β-HCG均呈正相关关系(P0.05),Cys C与β-HCG也呈正相关关系(P0.05)。结论:检测血清中瘦素、Cys C和β-HCG水平有利于妊娠高血压的诊断,体检时发现上述物质异常升高要高度重视。     

Increased Cytokine and Nitric Oxide Levels in Serum of Dogs Experimentally Infected with Rangelia vitalii

This study aimed to measure the levels of interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukin 1 (IL-1), interleukin 6 (IL-6), and nitrite/nitrate (NO_x) in serum of dogs experimentally infected with Rangelia vitalii. Twelve female mongrel dogs were divided into 2 groups; group A (uninfected controls) composed by healthy dogs (n=5) and group B consisting of dogs inoculated with R. vitalii (n=7). Animals were monitored by blood smear examinations, which showed intraerythrocytic forms of the parasite on day 5 post-infection (PI). Blood samples were collected through the jugular vein on days 0, 10, and 20 PI to determine the serum levels of IFN-γ, TNF-α, IL-1, IL-6, and NO_x. Cytokines were assessed by ELISA quantitative sandwich technique, and NO_x was measured by the modified Griess method. Cytokine levels (IFN-γ, TNF-α, IL-1, and IL-6) were increased (P<0.01) in serum of infected animals. Serum levels of NO_x were also increased on days 10 PI (P<0.01) and 20 PI (P<0.05) in infected animals. Therefore, the infection with R. vitalii causes an increase in proinflammatory cytokines and nitric oxide content. These alterations may be associated with host immune protection against the parasite.     

Multiple KIR gene polymorphisms are associated with plasma viral loads in SIV-infected rhesus macaques

Innate immune mechanisms play a deterministic role in the rate of disease progression during acute infection in HIV infected humans and SIV infection of non-human primates. The role NK cells play in mediating such an effect has thus gained importance. One of the major sets of molecules that regulate NK cell function are the killer cell immunoglobulin-like molecules (KIR’s). Our laboratory has previously shown an association of KIR3DL alleles 13 and 14 with high plasma viral loads in a cohort of SIV-infected rhesus macaques. To gain a more detailed understanding of the role of KIR polymorphisms, our laboratory herein conducted studies of three additional KIR loci and show that select KIR3DH alleles appear to be more strongly associated with high plasma viral loads than KIR3DL alleles 13 and 14. In addition, we herein document the existence of additional new alleles for the KIR1D, KIR2DL4, and the KIR3DH loci.     

HIV感染患者血清IL-2、IL-16水平和CD4细胞计数的相关性分析

目的:探讨人类免疫缺陷病毒(HIV)感染患者血清白细胞介素-2(IL-2)、白细胞介素-16(IL-16)水平和CD4细胞计数的相关性。方法:选择2017年3月至2018年3月我院接诊的50例HIV感染患者作为观察组及同期于我院进行体检的健康人群40例作为对照组。检测和比较两组血清IL-2、IL-16与CD4细胞计数,并分析观察组血清IL-2、IL-16与CD4细胞计数的相关性。结果:观察组患者血清IL-2、IL-16水平及CD4细胞计数显著低于对照组,差异具有统计学意义(P0.05);Pearson相关分析结果显示观察组患者血清IL-2、IL-16水平与CD4细胞计数呈显著正相关(r=0.514,r=0.499,P0.05)。结论:HIV感染患者血清IL-2、IL-16水平显著下调,并与CD4细胞计数呈显著正相关,可在一定程度上反映HIV感染的严重度。     

单纯性肥胖儿童血清Hcy、visfatin、E-FABP水平与糖脂代谢紊乱和炎症因子的相关性分析

摘要 目的：研究单纯性肥胖儿童血清同型半胱氨酸（Hcy）、内脂素（visfatin）、上皮型脂肪酸结合蛋白（E-FABP）水平与糖脂代谢紊乱和炎症因子的相关性。方法：将2019年4月～2020年10月于我院就诊的70例单纯性肥胖儿童纳入研究,记作肥胖组。另取同期于我院接受体检的健康儿童70例作为对照组。检测并比较两组血清Hcy、visfatin、E-FABP水平,糖脂代谢紊乱相关指标和炎症因子水平。以Pearson相关性分析明确单纯性肥胖儿童血清Hcy、visfatin、E-FABP水平与糖脂代谢紊乱和炎症因子的关系。结果：肥胖组血清Hcy、visfatin、E-FABP水平均高于对照组（均P＜0.05）。肥胖组空腹血糖（FPG）、空腹胰岛素（FINS）水平及胰岛素抵抗指数（HOMA-IR）均高于对照组（均P＜0.05）。肥胖组总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）水平均高于对照组,而高密度脂蛋白胆固醇（HDL-C）水平低于对照组（均P＜0.05）。肥胖组血清白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）水平均高于对照组（均P＜0.05）。经Pearson相关性分析可得：单纯性肥胖儿童血清Hcy、visfatin、E-FABP水平与FPG、FINS、HOMA-IR、TC、TG、LDL-C、IL-1β、IL-6、TNF-α水平均呈正相关,而与HDL-C水平呈负相关（均P＜0.05）。结论：单纯性肥胖儿童血清Hcy、visfatin、E-FABP水平均异常升高,且与其糖脂代谢紊乱及炎症反应密切相关,值得临床重点关注。     

脑胶质瘤患者血清VTN、IGFBP、UBE2C水平与临床病理特征和预后的关系研究

摘要 目的：研究脑胶质瘤患者血清玻连蛋白（VTN）、类胰岛素样生长因子结合蛋白（IGFBP）、泛素耦联酶2C（UBE2C）水平与临床病理特征和预后的关系。方法：将新疆医科大学第一附属医院从2019年1月～2020年1月收治的97例脑胶质瘤患者纳入研究,记作研究组,另取同期于本院进行体检的健康志愿者90例作为对照组。此外,对所有研究组人员均进行为期1年的随访,将其按照随访结局的差异分作死亡组40例和存活组57例。检测并比较各组血清VTN、IGFBP、UBE2C水平,分析血清VTN、IGFBP、UBE2C水平与脑胶质瘤患者临床病理特征和预后的关系,并以受试者工作特征（ROC）曲线分析血清VTN、IGFBP、UBE2C水平预测脑胶质瘤患者死亡的效能。结果：研究组血清VTN、IGFBP及UBE2C水平均高于对照组（均P＜0.05）。肿瘤大小≥5 cm、世界卫生组织（WHO）分级为Ⅲ～Ⅳ级、Karnofsky功能状态（KPS）＜70分脑胶质瘤患者的血清VTN、IGFBP水平均高于肿瘤大小＜5 cm、WHO分级为Ⅰ～Ⅱ级、KPS评分≥70分的脑胶质瘤患者（均P＜0.05）;WHO分级为Ⅲ～Ⅳ级、KPS评分＜70分脑胶质瘤患者的血清UBE2C水平高于WHO分级为Ⅰ～Ⅱ级、KPS评分≥70分的脑胶质瘤患者（均P＜0.05）。死亡组血清VTN、IGFBP、UBE2C水平均高于存活组（均P＜0.05）。经ROC曲线分析发现：血清VTN、IGFBP、UBE2C水平联合检测预测脑胶质瘤患者死亡的曲线下面积、灵敏度、特异度及约登指数均高于上述三项指标单独检测。结论：脑胶质瘤患者血清VTN、IGFBP、UBE2C水平均存在异常高表达,且与肿瘤恶性进展相关,联合检测可能有利于预测患者的预后。     

Heterophils are associated with resistance to systemic Salmonella enteritidis infections in genetically distinct chicken lines

Heterophils mediate acute protection against Salmonella in young poultry. We evaluated susceptibility of genetically distinct lines of broilers to systemic Salmonella enteritidis (SE) infections. SE was administered into the abdomen of day-old chickens (parental lines [A and B]; F1 reciprocal crosses [C and D]) to assess modulation of leukocytes and survivability of chickens. Line A was more resistant to SE than line B; likewise cross D was more resistant than cross C. Significantly more heterophils migrated to the abdominal cavity post-infection in the resistant lines. These data indicate that increased heterophil influx to the infection site contributes to increased resistance against systemic SE infections in neonatal chickens.     

老年2型糖尿病患者血清BGP、ghrelin、YKL-40水平与胰岛素抵抗及认知功能损害的关系研究

摘要 目的：研究老年2型糖尿病（T2DM）患者血清骨钙素（BGP）、生长激素释放多肽（ghrelin）及人软骨糖蛋白-39（YKL-40）水平与胰岛素抵抗及认知功能损害的关系。方法：选择2018年1月～2019年12月我院收治的老年T2DM患者100例记作病变组,选择同期于我院进行体检的老年健康志愿者100例作为对照组。比较两组血清BGP、ghrelin及YKL-40水平,血糖、血脂、胰岛素抵抗相关指标及简易智力状态检查量表（MMSE）评分情况,并分析各指标的相关性。结果：病变组血清BGP、ghrelin水平低于对照组,而YKL-40水平高于对照组（P＜0.05）。病变组空腹血糖（FPG）、糖化血红蛋白（HbA1c）水平及胰岛素抵抗指数（HOMA-IR）均高于对照组,而空腹胰岛素（FINS）水平低于对照组（P＜0.05）。病变组除语言、延迟记忆评分与对照组对比差异无统计学意义（P＞0.05）,其他各项MMSE评分均低于对照组（P＜0.05）。经Pearson相关性分析可得：老年T2DM患者血清BGP、ghrelin水平和FPG、HbA1c、HOMA-IR均呈负相关,与FINS及MMSE评分均呈正相关（P＜0.05）;而血清YKL-40水平和FPG、HbA1c、HOMA-IR均呈正相关,与FINS及MMSE评分均呈负相关（P＜0.05）。结论：老年T2DM患者的血清BGP、ghrelin存在明显低表达,而血清YKL-40水平呈明显高表达,且上述血清学指标水平均与胰岛素抵抗和认知功能损害密切相关。     

冠心病患者血清IMA、cathepsin S、RBP4水平与炎性因子及心肌缺血程度的相关性研究

摘要 目的：探讨血清缺血修饰白蛋白（IMA）、组织蛋白酶S（cathepsin S）、视黄醇结合蛋白4（RBP4）水平与冠心病患者炎性因子、心肌缺血程度的相关性。方法：选择2017年2月至2019年10月我院收治的100例冠心病患者,根据心肌缺血程度分为稳定型心绞痛组（34例）、不稳定型心绞痛组（42例）、急性心肌梗死组（24例）。检测并比较患者血清IMA、cathepsin S、RBP4、炎性因子[白介素-6（IL-6）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）]水平,分析IMA、cathepsin S、RBP4与炎性因子、SYNTAX积分的相关性,采用多元有序Logistic回归分析影响冠心病患者心肌缺血程度的因素。结果：冠心病患者心肌缺血程度越严重,血清IMA、cathepsin S、RBP4及炎性因子水平越高（P＜0.05）。Pearson相关性分析结果显示,血清IMA、cathepsin S、RBP4水平与炎性因子、SYNTAX积分均呈正相关（P＜0.05）。多元有序Logistic回归分析结果显示,高CRP、IMA、cathepsin S、RBP4水平是冠心病心肌缺血程度的影响因素（OR=1.702、1.183、1.881、2.003,P＜0.05）。结论：血清IMA、cathepsin S、RBP4水平与冠心病患者心肌缺血程度及炎性因子有关,IMA、cathepsin S、RBP4可能与炎症反应共同作用参与冠心病发病过程。     

血必净联合利奈唑胺注射液对老年重症肺炎患者血清肺表面活性蛋白、基质金属蛋白酶及其组织抑制剂水平的影响

目的:探讨血必净联合利奈唑胺注射液治疗老年重症肺炎患者的临床疗效及对患者血清肺表面活性蛋白(Pulmonary surfactant protein,SP)、基质金属蛋白酶(Matrix metalloproteinases,MMPs)及其组织抑制剂(Matrix metalloproteinases tissue inhibitor,TIMPs)水平的影响。方法:选择我院2015年6月～2017年12月收治的101例老年重症肺炎患者,按随机数字表法分为对照组(n=48)和研究组(n=53)。对照组采用利奈唑胺注射液治疗,研究组在对照组基础上采用血必净治疗。比较两组临床疗效,细菌清除情况,症状缓解时间,治疗前后血清SP、MMPs、TIMPs水平的变化,动脉血气,肺功能,不良反应的发生情况和28天内病死率。结果:治疗后,研究组有效率、细菌清除率均显著高于对照组(均P0.05),发热消失、血常规恢复、痰液颜色改变及胸部影像明显吸收时间均明显短于对照组(P0.05);两组血清SP-A、SP-B、SP-C、SP-D、MMP-2、MMP-9及TIMP-1及TIMP-2、血氧饱和度(blood oxygen saturation,SaO_2)、动脉血二氧化碳分压(arterial blood,PaCO_2)、动脉血二氧化碳分压(arterial blood CO_2 partial pressure of CO_2 partial pressure,PaCO_2)、峰流速(peak velocity of flow,PEF)水平均较治疗前显著下降,而血氧饱和度(blood oxygen saturation,SaO_2)、氧分压(oxygen partial pressure,PaO2)、最大呼气中段流量(maximum tidal midexpiratory flow,MMF)、用力肺活量(forced vital capacity,FVC)均较治疗前明显上升,且研究组以上指标变化较对照组更明显(均P0.05)。两组不良反应的发生情况比较差异无统计学意义(P0.05),而研究组在28天内病死率显著低于对照组(P0.05)。结论:血必净联合利奈唑胺注射液对老年重症肺炎患者的疗效优于单用利奈唑胺注射液治疗,可能与其显著降低患者血清SP、MMPs及TIMPs水平,改善肺功能,降低病死率有关。     

不同分期慢性肾脏病患者血清Klotho蛋白、FGF-23、RBP4、TWEAK水平与肾功能的相关性研究

摘要 目的：探究不同分期慢性肾脏病(CKD)患者血清Klotho蛋白、成纤维细胞生长因子-23(FGF-23)、视黄醇结合蛋白4(RBP4)、肿瘤坏死因子样弱凋亡诱导因子(TWEAK)水平与肾功能的相关性。方法：选择2018年2月至2020年2月我院诊治的80例CKD患者作为CKD组,选择同期在我院进行健康体检的80名健康者作为对照组。检测并比较对照组和CKD组以及不同CKD分期患者血清Klotho蛋白、FGF-23、RBP4、TWEAK水平及肾功能指标水平,采用Pearson相关性分析对血清Klotho蛋白、FGF-23、RBP4、TWEAK水平与肾功能指标的相关性进行分析。结果：与对照组相比,CKD组血清Klotho蛋白、TWEAK水平和肾小球滤过率（GFR）明显下降,而血清FGF-23、RBP4水平、血清肌酐、24尿蛋白定量和血清尿素氮水平明显升高（P<0.05）。Ⅰ～Ⅱ期患者的血清Klotho蛋白、TWEAK水平和GFR最高,其次为Ⅲ～Ⅳ期患者,Ⅴ期患者最低（P<0.05）。而Ⅰ～Ⅱ期患者血清FGF-23、RBP4水平、血清肌酐、24尿蛋白定量和血清尿素氮水平最低,其次为Ⅲ～Ⅳ期患者,Ⅴ期患者最高（P<0.05）。Klotho蛋白和TWEAK水平与血清肌酐、24尿蛋白定量和血清尿素氮水平呈负相关,与GFR呈正相关（P<0.05）。FGF-23和RBP4水平与血清肌酐、24尿蛋白定量和血清尿素氮水平呈正相关,与GFR呈负相关（P<0.05）。结论：CKD患者中血清Klotho蛋白、TWEAK水平以及肾功能下降,FGF-23、RBP4水平明显升高,且血清Klotho蛋白、TWEAK、FGF-23、RBP4水平与肾功能及CKD分期相关。     

新诊断2型糖尿病患者血清Pannexin-1、Apelin、RBP4、VEGF水平与糖脂代谢和胰岛素抵抗的关系研究

摘要 目的：探讨新诊断2型糖尿病患者血清缝隙连接蛋白-1(Pannexin-1)、爱帕琳肽（Apelin）、视黄醇结合蛋白4(RBP4)、血管内皮生长因子（VEGF）水平与糖脂代谢和胰岛素抵抗的关系。方法：选择2018年2月至2020年2月我院诊治的120例新诊断2型糖尿病患者作为糖尿病组,选择同期在我院进行体检的120例健康者作为对照组。检测所有受试者甘油三酯（TG）、总胆固醇（TC）、谷草转氨酶（AST）、谷丙转氨酶(ALT)、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）水平、空腹血糖（FPG）、空腹胰岛素(FINS)、Pannexin-1、Apelin、RBP4、VEGF水平,计算胰岛素抵抗指数(HOMA-IR)、胰岛素敏感性指数（ISI）和胰岛?茁细胞功能指数(HOMA-β)。分析Pannexin-1、Apelin、RBP4、VEGF水平与糖脂代谢和胰岛素抵抗相关指标的关系,分析影响上述指标表达的相关因素。结果：与对照组相比,糖尿病组体质量指数（BMI）、TG、TC、FPG、FINS、Pannexin-1、Apelin、RBP4、VEGF水平,HOMA-IR明显升高（P<0.05）,ISI和HOMA-β明显下降（P<0.05）。新诊断2型糖尿病患者血清Pannexin-1、Apelin、RBP4、VEGF水平与ISI和HOMA-β均呈负相关（P<0.05）,与BMI、TG、TC、FPG、FINS、HOMA-IR均呈正相关（P<0.05）。TG与Pannexin-1表达联系密切（β=0.006,P<0.05）,ISI和HOMA-IR与Apelin表达联系密切（β=-6.673、0.049,P<0.05）,FPG和TC与RBP4表达联系密切（β=22.309、0.506,P<0.05）,HOMA-IR与VEGF表达联系密切（β=0.574,P<0.05）。结论：新诊断2型糖尿病患者血清Pannexin-1、Apelin、RBP4、VEGF水平异常升高,并参与新诊断2型糖尿病患者的糖脂代谢和胰岛素抵抗,在2型糖尿病的诊断和预防中有一定临床价值。     

腰大池引流联合法舒地尔治疗动脉瘤性蛛网膜下腔出血的疗效及对血清sICAM-1、FABP、MCP-1水平和脑积水形成的影响

目的:分析腰大池引流联合法舒地尔治疗动脉瘤性蛛网膜下腔出血的疗效及对血清可溶性细胞间黏附分子-1(sICAM-1)、脂肪酸结合蛋白质(FABP)、核细胞趋化蛋白(MCP-1)水平和脑积水形成的影响。方法:选择我院2016年3月~2018年3月收治的112例动脉瘤性蛛网膜下腔出血患者,按随机数字表法分为对照组(n=48)和研究组(n=64)。对照组采用腰大池引流治疗,研究组基于对照组联合法舒地尔治疗。比较两组临床疗效,治疗前后血清sICAM-1、FABP、MCP-1水平、血压、大脑中动脉血流参数水平和神经功能的变化,脑积水发生率及不良反应发生情况。结果:治疗后,研究组总有效率显著高于对照组(89.02%vs.72.91%,P<0.05)。两组治疗后血清sICAM-1、FABP、MCP-1、血压、大脑中动脉血流参数水平和神经功能缺损评分量表(NIHSS)均较治疗前下降,格拉斯哥昏迷评分(GCS)均较治疗前上升,研究组以上指标较对照组改变更明显(均P<0.05)。两组不良反应发生情况比较差异无统计学意义(P>0.05)。结论:腰大池引流联合法舒地尔治疗动脉瘤性蛛网膜下腔出血的疗效明显优于单用腰大池引流治疗,其可显著降低血清sICAM-1、FABP、MCP-1水平,降低脑积水发生率,改善患者预后。