Significant effects of biologic therapy on lipid profiles and insulin resistance in patients with rheumatoid arthritis

IntroductionThe goal of this study was to investigate (1) the associations of rheumatoid arthritis (RA)-related inflammation or rheumatoid factor/anti-cyclic citrullinated peptide (anti-CCP) positivity with lipid profiles and insulin resistance (IR), (2) the effects of biologic therapy on lipid profiles and IR, and (3) potential predictors for the presence of subclinical atherosclerosis.MethodsSerum levels of lipid profiles were determined by enzymatic methods in 32 adalimumab-treated patients, 16 etanercept-treated patients, 24 tocilizumab-treated patients, and 20 biologic-naïve patients. Atherogenic index, which corresponds to the ratio of total cholesterol to high-density lipoprotein cholesterol (HDL-C), was calculated. IR was measured by homeostasis model assessment. Pro-inflammatory cytokine levels were examined by enzyme-linked immunosorbent assay. Common carotid artery intima-media thickness was determined by using sonography.ResultsThere was an inverse correlation between disease activity (disease activity score for 28 joints, or DAS28) and low-density lipoprotein cholesterol (LDL-C) levels (r = −0.226, P <0.05) and a positive correlation between DAS28 and IR (r = 0.361, P <0.005). Anti-CCP-positive patients had significantly higher DAS28 and IR compared with anti-CCP-negative patients. There was also a positive correlation between IR and levels of interleukin-6 or tumor necrosis factor-alpha (TNF-α). HDL-C levels significantly increased in patients receiving 6-month anti-TNF-α therapy, and levels of total cholesterol, LDL-C, and triglyceride increased in tocilizumab-treated patients. IR significantly decreased in patients under biologic therapy but was unchanged in biologic-naïve patients. Age, IR, and DAS28 were significant predictors of severe subclinical atherosclerosis (odds ratios of 1.08, 2.77, and 2.52, respectively).ConclusionsSignificant associations of RA-related inflammation with lipid profiles and IR indicate the involvement of RA in atherosclerosis pathogenesis. Biologic therapies were associated with IR reduction without change in atherogenic index, but their beneficial effects on atherosclerosis reduction need to be verified in the future.     

N-酰化低聚壳聚糖衍生物还原能力的研究

对低聚壳聚糖进行N-酰化改性,制得取代度相同的N-马来酰低聚壳聚糖(NMCOS),N-琥珀酰低聚壳聚糖(NSCOS),N-邻苯二甲酰低聚壳聚糖(NPCOS),其中NMCOS1、NSCOS1、NPCOS1的取代度均为0.25;NMCOS2、NSCOS2、NPCOS2的取代度均为0.49。考察了6种N-酰化低聚壳聚糖衍生物的还原能力。结果表明:当取代度相同时,N-邻苯二甲酰低聚壳聚糖的还原能力最强,其次是N-马来酰低聚壳聚糖,N-琥珀酰低聚壳聚糖的还原能力最差。这可能是由取代基的性质不同所致。     

小型猪体外循环下心脏手术的麻醉

目的研究医学手术实验用小型猪体外循环下心脏手术的麻醉管理及麻醉效果。方法实验用小型猪34例,分为CPB下停跳组手术组（停跳组,18例）及CPB下并行手术组（并行组,16例）,行自体心包片三尖瓣置换术。记录实验中麻醉药物及血管活性药用量,基础麻醉、麻醉维持及麻醉苏醒时间,术后3天、一周存活状况等,并评价基础麻醉及全麻效果。结果 34例均在全麻下顺利完成手术,各期血流动力学平稳,仅停跳组一例术后3天内死亡,存活率97.1%,麻醉效果良好。结论合理的麻醉药物与血管活性药物的联合应用,仔细的临床观察与正确而迅速的处理是小型猪体外循环下心脏手术麻醉的关键。     

一多重耐药单增李斯特菌株的生长特性及毒力分析

为了解单增李斯特菌株耐药后可能发生的生物学变化,以哈市生肉中分离到的1株对17种抗生素耐受的单增李斯特菌株L.M.B8为研究对象,对其生长及毒力特性进行研究。结果显示,L.M.B8的生长及毒力特性均与标准菌株有明显差异。在NaC l浓度为0.5%~5%、pH值为4.0~10.0及温度为20~45℃范围内,L.M.B8的生长速度均明显高于标准菌株。L.M.B8对高浓度盐的敏感性高于标准菌株,且对温度的适应能力强于标准菌株。从生长曲线看,L.M.B8的对数生长期与稳定期均较标准菌株提前2~3 h,且其稳定期较标准菌株明显缩短。L.M.B8小鼠腹腔注射半数致死量（LD50）较标准菌株明显降低。该研究为进一步探讨单增李斯特菌的耐药性与其他生物学特性的相关性奠定基础。     

不同品种苦荞麦不同器官总黄酮含量的比较分析

Total flavonoids content in stems,leaves and seeds of seven cultivars of Fagopyrum tataricum(L.) Gaertn.and a cultivar of F.esculentum Moench were determined by UV-visible spectrophotometry.The results show that total flavonoids content in leaves is higher.Total flavonoids content among different cultivars of F.tataricum has a great difference.Among seven cultivars of F.tataricum,total flavonoids content is the highest in leaves and seeds of ’Jiande Tartary Buckwheat’ with 106.16 and 24.09 mg·g-1,respectively,and in stems of ’Dingbian Tartary Buckwheat’ with 34.65 mg·g-1.The comprehensive analysis result indicates that ’Jiande Tartary Buckwheat’ is the best germplasm resources of F.tataricum and worth to further extension.     

GNMT expression increases hepatic folate contents and folate-dependent methionine synthase-mediated homocysteine remethylation

Glycine N-methyltransferase (GNMT) is a major hepatic enzyme that converts S-adenosylmethionine to S-adenosylhomocysteine while generating sarcosine from glycine, hence it can regulate mediating methyl group availability in mammalian cells. GNMT is also a major hepatic folate binding protein that binds to, and, subsequently, may be inhibited by 5-methyltetrafolate. GNMT is commonly diminished in human hepatoma; yet its role in cellular folate metabolism, in tumorigenesis and antifolate therapies, is not understood completely. In the present study, we investigated the impacts of GNMT expression on cell growth, folate status, methylfolate-dependent reactions and antifolate cytotoxicity. GNMT-diminished hepatoma cell lines transfected with GNMT were cultured under folate abundance or restriction. Folate-dependent homocysteine remethylation fluxes were investigated using stable isotopic tracers and gas chromatography/mass spectrometry. Folate status was compared between wild-type (WT), GNMT transgenic (GNMT(tg)) and GNMT knockout (GNMT(ko)) mice. In the cell model, GNMT expression increased folate concentration, induced folate-dependent homocysteine remethylation, and reduced antifolate methotrexate cytotoxicity. In the mouse models, GNMT(tg) had increased hepatic folate significantly, whereas GNMT(ko) had reduced folate. Liver folate levels correlated well with GNMT expressions (r = 0.53, P = 0.002); and methionine synthase expression was reduced significantly in GNMT(ko), demonstrating impaired methylfolate-dependent metabolism by GNMT deletion. In conclusion, we demonstrated novel findings that restoring GNMT assists methylfolate-dependent reactions and ameliorates the consequences of folate depletion. GNMT expression in vivo improves folate retention and bioavailability in the liver. Studies on how GNMT expression impacts the distribution of different folate cofactors and the regulation of specific folate dependent reactions are underway.     

健康宣教在小儿狭窄性腱鞘炎围手术期应用价值

目的：对手术疗法治疗狭窄性腱鞘炎的小儿患者采取系统的整体健康宣教,使得患儿疗程缩短,治愈率高,复发率降至最低,功能康复效果良好,提高护理质量。方法：在保守治疗无效的情况下,手术疗法切除部分狭窄腱鞘,围手术期实施系统的全面的功能康复训练及宣教。结果：54例患儿完全治愈,随访3~26个月,无复发及并发症,愈后功能良好。结论：细致、周密的做好围手术期对家长及患儿的双重健康宣教工作,使得护患关系融洽,患者自护能力大大加强,治疗及护理效果满意。     

假瘤蕨属 (水龙骨科) 植物叶表皮特征的比较研究

在光镜和扫描电镜下观察了假瘤蕨属2系、5亚系的24种植物的叶表皮。结果表明,叶表皮细胞形状不规则,垂周壁波曲状。下生气孔,气孔类型有极细胞型、共环极细胞型、腋下细胞型、聚腋下细胞型和不规则型,常伴生出现。在扫描电镜下,叶表皮气孔器外拱盖内缘为浅波状、少平滑;一些种的保卫细胞两端有“T”型加厚;角质膜波状有条纹,有时附有颗粒。叶表皮的一些特征对该属部分种的区分有一定的参考价值。叶表皮的微形态特征,如气孔器类型和垂周壁类型特征不能用来界定假瘤蕨属的系和亚系。     

胰十二指肠切除术后肠黏膜屏障损伤与肠道细菌移位的临床研究

目的:探讨胰十二指肠切除手术后肠道细菌移位(BT)与术后全身炎症反应综合征(SIRS)关系。方法:40例择期行胰十二指肠切除手术患者,于术前和术后1、3、5天采集外周血,进行血浆D-乳酸,全血细菌DNA检测.全血DNA提取后进行PCR扩增,采用靶基因为大肠杆菌特异性β半乳糖苷酶基因和16SrRNA基因。观察患者术后10天以监测SIRS情况。结果:术前PCR检测全血细菌DNA均为阴性,术后共有13例阳性。术后出现全身炎症反应综合征(SIRS)的患者PCR阳性率为85.7%(12/14),无SIRS组为3.8%(1/26()P<0.01)。PCR阳性组SIRS发生率为93.2%(12/13),阴性组为7.4%(2/27)(P<0.01).PCR阳性的患者外周血血浆D-乳酸浓度较PCR阴性者明显升高(P<0.01),有SIRS的患者外周血血浆D-乳酸浓度较无SIRS患者明显升高(P<0.01)。结论:胰十二指肠切除术后肠黏膜屏障损伤与BT关系密切,术后SIRS和与BT密切相关。PCR技术对术后SIRS有较好的早期预警价值。     

中药地黄饮子对小鼠抗体激发水平的影响

目的:探讨地黄饮子对小鼠抗体激发水平的影响。方法:将40只经卵核蛋白免疫过的小鼠随机分A、B两组,分别灌服地黄饮子和葡萄糖,1次/d,每次0.5mL只,连续7d后,加强免疫,再经7d,用ELISA法检测血清中相应抗体生成水平。结果:与葡萄糖组比较,地黄饮子组小鼠抗体水平升高,差异有显著性意义(P<0.05)。结论:地黄饮子有可能促进小鼠抗体激发水平和免疫水平的提高。