重组人生长激素治疗生长激素缺乏症的疗效观察

目的：正确评价重组人生长激素（rhGH）治疗儿童生长激素缺乏症（GHD）的疗效。方法：GHD患儿47例,给予rhGH0．1U／（kg．d）,疗程3个月,并对其疗效进行观察。结果：身高（height）由（122±17．67）cm增至（125．32±17．50）cm,生长速率（growthrate）由〈4cm／年增加到（10．40±3．74）cm／年。血清碱性磷酸酶（AKP）由（207±48．11）IU／L增至（261±45．29）IU／L。I型前胶原羧基端伸展肽（PICP）由（97．80±14．94）ng／ml增至（119．50±24．10）ng／ml值。肌酐（Cr）由（40．20±8．28）umol／L变为（36．50±8．33）umol／L值。结论：rhGH是治疗GHD有效的药物。     

重组人生长激素的主要药效学研究

参照文献方法,观察了ｒｈＧＨ对正常大鼠（３月龄,平台期）生长发育作用的影响,ｉｍ,ｒｈＧＨ（０．０５、０．１５、０．４５ｍｇ．ｋｇ＾－１．ｄ＾－１）,连续１５天,结果表明：ｒｈＧＨ（０．１５、０．４５ｍｇ．ｋｇ＾－１．ｄ＾－１）同阳性对照生长激素ＮＩＢＳＣ标准品）一样,均可明显促进正常平台期大鼠的体重及尾长增加,大剂量组还可明显促进肝、肾及骨骼的生长发育,使肝、肾重量增加,胫骨骨骺端距离增大,同     

血BNP 监测对慢性心力衰竭患者治疗的指导价值及其对预后 的影响研究

目的:探讨血浆脑钠肽(BNP)监测对慢性心力衰竭(CHF)患者治疗的指导价值及其对预后的影响。方法:根据出院后是否进行BNP监测,将2009年5月至2010年12月我院心内科出院的CHF患者100例随机分为监测组和对照组,每组各50例。平均随访时间为1年,观察两组的治疗效果和预后包括心血管性死亡、因心血管事件再次住院例数、NYHA心功能分级、明尼苏达心衰生活质量问卷(MLHFQ)评分。结果:随访1年期间,监测组心血管性死亡率、因心血管事件再次住院率分别为2%、18.0%,对照组分别为16.0%、54.0%,差异均有统计学意义(P<0.05)。出院时与第1次随访,两组患者明尼苏达心衰生活质量问卷评分结果比较差异无统计学意义(P>0.05);而第2、3、4次随访时,监测组试验结果均显著高于对照组,差异有统计学意义(P<0.05)。随访1年时,监测组患者的NYHA心功能分级、抗心衰药物的靶剂量率显著优于对照组,差异有统计学意义(P<0.05)。结论:通过血浆BNP水平监测,及时调整治疗方案,可延缓心衰的进展,改善患者预后。     

用重组大肠杆菌发酵生产人生长激素研究

通过不同培养基、不同糖浓度对重组菌Ｅ．ｃｏｌｉＤＨ１０Ｂ／ｐＩＮⅢＡ３ＨＧＨ的菌体生长与外源蛋白表达量的影响的比较，确定较为合适的培养条件，并对发酵过程中调节ｐＨ的氨水用量与外源蛋白的表达量之间的相关性作探索，得到相关性曲线，从而根据氨水用量了解细菌的生长状况。     

康复运动治疗老年慢性心力衰竭患者的有效性和安全性研究

目的:探讨6周康复运动治疗老年慢性心力衰竭(心衰)患者的有效性和安全性。方法:44例老年慢性心力衰竭(心功能NYHAⅡ-Ⅲ)患者随机分为两组,康复组在实施临床医疗措施并同时进行6周康复运动;对照组仅实施临床医疗措施。比较治疗前后及不同两组治疗后的六分钟步行实验距离,完成运动平板所需要的时间和代谢当量,明尼苏达心力衰竭生活质量调查表积分,血浆脑钠肽含量以及左室射血分数。结果:经过6周康复运动治疗后康复组心功能分级、六分钟步行实验距离、运动平板时间和运动平板的最大代谢当量(METS)较对照组改善更明显(P<0.05)。结论:6周康复运动治疗显著提高老年慢性心力衰竭患者的运动耐量和生活质量。6周康复运动治疗老年慢性心力衰竭(心衰)患者是有效的和安全的。     

慢性心力衰竭患者自我管理的现状及影响因素分析

目的：了解慢性心力衰竭患者自我管理的现状及影响因素。方法：采用自行设计的心力衰竭自我管理量表、心力衰竭知识测评量表、患者信息调查表和社会支持评定量表、抑郁自评量表调查160 例慢性心力衰竭患者的现状。结果：心衰患者自我管理状况呈中等水平,自我管理水平与教育程度、心衰相关知识水平以及社会支持程度呈中度正相关关系,与抑郁情绪和年龄呈中度负相关关系。结论：慢性心衰患者自我管理水平受其生理、心理及社会等多因素的影响。     

大肠杆菌表达重组人生长激素的纯化

目的 :获得具有生物学活性的重组人生长激素 (rhGH)。方法 :PBV -GH/DH5α菌体经超声破菌、反复洗涤后获得包涵体。将包涵体变性、复性 ,用硫酸铵盐析 ,离子交换层析和凝胶层析进行纯化。产物经SDS -PAGE、HPLC、N末端 15个氨基酸序列检测验证。结果 :终产物rhGH纯度达 98.2 % ,比活性大于 3.0IU/mg。分子量为 2 2kDa ,N末端氨基酸序列与DNA序列推导的氨基酸序列完全一致。结论 :从自构建的PBV -GH/DH5α工程菌中获得高纯度、高活性重组人生长激素。其纯化工艺为中试生产提供可靠依据。     

转移人生长激素基因和注射人生长激素对促进银鲫生长的研究

本研究将人生长激素基因重组 DNA 导入银鲫受精卵,或用人生长激素对60日龄银鲫连续6周腹腔注射,均观察到了受体鱼的快速生长效应,转移人生长激素基因鱼在60日龄时的平均体重比对照鱼平均体重增加82%,相应体长平均值比对照鱼增加19.7%;在125日龄时,转基因组平均体重比对照组增加17.7%,相应体长平均值比对照增加3.5%。定期注射人生长激素,在6周的注射实验过程中,实验鱼的体重,体长都与对照组相近或略有减小。但是,在水泥池中饲养一个月后,注射10/μg/g 体重的实验组鱼平均体重比相应对照组鱼的平均体重增加32%;相应体长平均值增加11%。     

黄芪注射液对慢性心力衰竭患者BNP水平的影响

目的:探究黄芪注射液对慢性心力衰竭患者外周血清B型脑利钠肽水平的影响。方法:选择2013年12月-2015年1月我院收治的慢性心力衰竭住院患者334例,按用药不同分为实验组和对照组。对照组患者采取常规药物口服治疗,实验组患者应用黄芪注射液静脉滴注。观察并比较两组患者治疗前后外周血B型脑利钠肽水平的变化情况。结果:治疗后,两组患者外周血B型脑利钠肽水平均明显下降,且实验组下降更明显,实验组Ⅰ级、Ⅱ级患者比例较对照组显著升高,差异均具有统计学意义(P0.05)。结论:黄芪注射液能够降低慢性心力衰竭患者的外周血B型脑利钠肽水平,改善其心功能,值得临床推广应用。     

肥胖症的重组人生长激素治疗探讨

本文叙述了肥胖症的病因,诊断标准及重组人生长激素治疗ＰｒａｄｅｒＷｉｌｉ综合征和成人肥胖症的探讨     

卡维地洛加安体舒通治疗慢性充血性心力衰竭疗效观察

目的:观察卡维地洛加安体舒通治疗慢性充血性心力衰竭(CHF)的疗效。方法:将CHF患者63例随机分成观察组与对照组,在常规强心、利尿基础上,观察组加卡维地洛、安体舒通治疗。对照组加依那普利治疗。时间为三个月。结果:两组对CHF患者心功能均明显改善,总有效率观察组为80％,对照组为67％。观察组优于对照组,P<0.05。观察组不良反应轻,对照组有3例患者分别出现咳嗽、皮疹。结论:卡维地洛加安体舒通治疗CHF优于依那普利,且无明显不良反应。     

Effect of recombinant growth hormone on expression of growth hormone receptor,insulin-like growth factor mRNA and serum level of leptin in growing pigs

Sixteen Large White × Landrace castrated male pigs were allotted into treatment and control group. The treatment group was injected intramuscularly with recombinant porcine growth hormone (rpGH, 4 mg d⁻¹) and the control group with vehicle for 28 days. Animals were slaughtered 4 h after final injection for liver, longissimus dorsi (LD) muscle and blood sampling. Serum concentration of insulin-like growth factor 1 (IGF-I) and leptin were determined by RIA. The total RNA was extracted from tissues to measure the abundance of growth hormone receptor (GHR), IGF-I mRNA by RT-PCR with 18S rRNA internal standard. Results showed that rpGH enhanced the average daily weight gain by 26.1% (P < 0.05), the serum IGF-I concentration by 70.94% (P < 0.01), decreased serum leptin by 34.8% (P < 0.01). The relative abundance of GHR and IGF-I mRNA in liver were increased by 24.45% (P < 0.05) and 45.30% (P < 0.01), respectively, but no difference of GHR (P > 0.05) and IGF-I mRNA (P > 0.05) in LD between GH treated and control group was found. These results suggest that rpGH can up-regulate hepatic GHR and IGF-I gene expression and improve animal growth. However the effect of rpGH on GHR and IGF-I gene expression are tissue-specific.     

Effect of recombinant growth hormone on expression of growth hormone receptor, insulin-like growth factor mRNA and serum level of leptin in growing pigs

Growth hormone (GH) plays an important role in regulation of animal growth, metabolism and lactation[1]. Numerous studies have shown that exogenous somatotropin (ST) can increase average daily weight gain, improve feed efficiency, stimulate protein deposition and muscle growth and decrease lipid accretion rate[1]. The original somatomedin hypothesis suggested that the effect of GH on postnatal growth was mediated by insulin-like growth hormone factor 1 (IGF-I) which was thought to be deriv…     

Usefulness of parathyroid hormone as a predictor of heart failure with preserved ejection fraction

Objective: To investigate the relation between parathyroid hormone (PTH) and heart failure with preserved ejection fraction (HF-PEF) in outpatients.

Methods: One hundred consecutive patients who had preserved left ventricular (LV) ejection fraction and heart failure (HF) symptoms, were enrolled. Echocardiography, assessing the diastolic functions was performed. Blood samples were collected for intact PTH and brain natriuretic peptide (BNP).

Results: Significant correlations between PTH level and predictors of advanced HF-PEF were found (p < 0.05). PTH level and left atrium diameter were found to be independent predictors of DHF.

Conclusion: Measurement of serum PTH provides complementary information for the diagnosis and prognosis of HF-PEF.     

重组人生长激素长效缓释的研究进展

重组人生长激素长效缓释制剂可提高药物生物利用度,延长药物半衰期,减少药物不良反应,给疾病的临床治疗提供了更多的手段和可能。从微球、脂质体、化学修饰等方面综述了重组人生长激素长效缓释的研究进展。     

Modulation of fatty acid-binding protein content of adult rat heart in response to chronic changes in plasma lipid levels

The aim of this work was to study in the adult rat heart the effect of modifications of fatty acid (FA) supply on the content of cytoplasmic fatty acid-binding protein (H-FABP_c). To modify the amount of circulating lipids, three different treatments were chosen: (i) an hypolipidemic treatment with Clofibrate, administered daily through a gastric tube at a dose of 250 mg/kg per day for one week, (ii) a continuous intravenous infusion of 20% Intralipid, a fat emulsion, for one week at a dose of 96 ml/kg per day, and (iii) a normobaric hypoxia exposure (pO₂=10%) for three weeks. At the end of each treatment plasma lipids, myocardial H-FABP_c content and the activities of three key enzymes (citrate synthase, CS, fructrose-6-phosphate kinase, FPK and hydroxy-acyl CoA-dehydrogenase, HAD) were assessed. With each of the three treatments a decrease of plasma cholesterol and phospholipid levels was observed. Plasma FA concentration increased with Intralipid infusion and decreased with chronic hypoxia. The heart H-FABP_c content was increased by 20% with Clofibrate, decreased by 20% with chronic hypoxia and remained unaltered upon Intralipid treatment. The induced changes in H-FABP_c content were not related directly to changes in plasma lipid levels. CS activity was slightly decreased in the hypoxia group, FPK activity decreased in the Clofibrate group, and HAD activity decreased in the Intralipid group. Among the various groups heart H-FABP_c content was related to HAD activity. In conclusion, the H-FABP_c content of adult rat heart appears responsive to changes in plasma lipid levels.     

Genetic risk scores to predict the prognosis of chronic heart failure patients in Chinese Han

Chronic heart failure (CHF) has poor prognosis and polygenic heritability, and the genetic risk score (GRS) to predict CHF outcome has not yet been researched comprehensively. In this study, we sought to establish GRS to predict the outcomes of CHF. We re‐analysed the proteomics data of failing human heart and combined them to filter the data of high‐throughput sequencing in 1000 Chinese CHF cohort. Cox hazards models were used based on single nucleotide polymorphisms (SNPs) to estimate the association of GRS with the prognosis of CHF, and to analyse the difference between individual SNPs and tertiles of genetic risk. In the cohort study, GRS encompassing eight SNPs harboured in seven genes were significantly associated with the prognosis of CHF (P = 2.19 × 10^?10 after adjustment). GRS was used in stratifying individuals into significantly different CHF risk, with those in the top tertiles of GRS distribution having HR of 3.68 (95% CI: 2.40‐5.65 P = 2.47 × 10^?10) compared with those in the bottom. We developed GRS and demonstrated its association with first event of heart failure endpoint. GRS might be used to stratify individuals for CHF prognostic risk and to predict the outcomes of genomic screening as a complement to conventional risk and NT‐proBNP.     

心源性睡眠呼吸异常：心衰患者睡眠期间陈-施呼吸 机制探讨的初步报告*

目的: 探讨心衰患者陈施呼吸的发生率及发生机制。方法: 连续入选2015年3月~2015年5月于阜外医院行睡眠呼吸监测的患者56例,分为心衰组和非心衰组。结果: 两组睡眠呼吸暂停的发生率均较高,心衰组11例患者中呼吸暂停低通气指数（AHI）>5的有10例,平均AHI指数23.93±14.63;非心衰组45例患者中AHI>5的有33例,平均AHI指数16.20±18.76;心衰组中枢性睡眠呼吸暂停（CSA）次数占睡眠呼吸暂停总数的比例明显大于非心衰组病人,分别为80.21%±30.55%和27.16%±35.71%,P<0.01。结论: 心脏的循环功能和肺脏的呼吸功能是联合一体化,相互联系、互为因果而又互相影响。慢性心力衰竭的循环障碍促成了潮式呼吸的发生,所以称之为心源性呼吸睡眠异常。     

门诊和住院运动锻炼为核心的整体管理对慢性心力衰竭患者心脏康复治疗效果影响的临床研究*

目的: 探讨门诊运动康复和住院运动康复对慢性心力衰竭（CHF）患者心脏康复治疗效果的影响。方法: 选择2015 年9 月至2018 年9 月间在北京康复医院临床诊断为CHF患者36 例,按照随机原则和患者参与意愿分为3组：对照组（n=12）：进行除运动锻炼治疗之外的常规心脏康复指导;住院运动康复组（n=12）和门诊运动康复组(n=12）：患者在我院分别住院或门诊进行运动锻炼为核心的心脏康复。根据心肺运动试验（CPET）制定个体化运动处方。功率车运动强度为无氧阈以上Δ50%功率负荷,30 min/d,每周5 d,共12 周。治疗前、后分别评估患者CPET指标、超声心动图指标、6 min步行距离（6MWD）、生活质量（QoL）评分等。结果: 所有CHF患者安全无并发症完成症状限制性CPET,运动康复组患者安全完成全程12 周运动康复。组间比较显示,治疗前,3组患者CPET指标、超声心动图指标、6MWD和QoL均无明显差异（P>0.05）。治疗后,住院和门诊运动康复组患者无氧阈（ml/min, ml/（min·kg）, %pred）、峰值摄氧量（ml/min, ml/（min·kg）, %pred）、峰值氧脉搏（ml/beat）、峰值功率（W, %pred）、左心室射血分数、6MWD较对照组升高（P<0.05）,QoL 评分较对照组降低（P<0.05）;门诊运动康复组和住院运动康复组之间比较,CPET指标、超声心动图指标、6MWD和QoL评分等均无明显差异（P>0.05）。治疗前后比较显示,对照组患者治疗后上述指标与治疗前比较,差异均无统计学意义（P>0.05）;治疗后住院运动康复组和门诊运动康复组患者无氧阈（ml/min, ml/（min·kg））、峰值摄氧量（ml/min, ml/（min·kg）, %pred）、峰值氧脉搏（ml/beat, %pred）、峰值功率（W/min、%pred）、左心室射血分数和6MWD均较治疗前升高（P<0.05）,QoL 评分较治疗前降低（P<0.05）。结论: 门诊运动康复可显著改善CHF患者心肺功能、运动耐力和生活质量,与住院运动康复效果无明显差异。门诊康复作为心脏康复一种有效的治疗模式,值得大力推广。