血清γ-谷氨酰转肽酶水平与老年2型糖尿病患者并发急性冠脉综合征的相关性分析

目的:探讨血清γ-谷氨酰转肽酶(GGT)水平与老年2型糖尿病患者并发急性冠脉综合征的相关性。方法:选取2015年10月至2016年10月哈尔滨市第一医院收治的老年患者238例,根据病情分为单纯2型糖尿病组81例(DM组),单纯急性冠脉综合征组78例(ACS组),2型糖尿病患者合并急性冠脉综合征79例(DA组);选取同期来我院体检健康者83例作为对照组(NC组)。比较各组一般情况和血清学指标。结果:(1)DA组BMI大于NC组、DM组和ACS组,血清GGT、糖化血红蛋白(HbA1C)、低密度脂蛋白胆固醇(LDL-C)水平显著高于NC组、DM组和ACS组,血清总胆固醇(TC)、甘油三酯(TG)水平均高于NC组,高密度脂蛋白胆固醇(HDL-C)水平低于NC组(P0.05)。(2)血清GGT水平与TG、LDC-C水平呈正相关(p0.05)。结论:血清GGT水平升高是老年2型糖尿病患者并发急性冠脉综合征的独立危险因素,及时监测老年2型糖尿病患者GGT水平对预测急性冠脉综合征的发生具有重要意义。     

RIFLE标准在高容量血液滤过治疗MODS患者疗效的评价

目的:探讨不同肾功能损害时期行高容量血液滤过(HVHF)治疗对多器官功能障碍综合征(MODS)疗效的影响。方法:采用RIFLE标准,将入选的MODS患者按急性肾损伤(AKI)分为AKIⅠ期(A组)、AKIⅡ期(B组)、AKIⅢ期(C组),以不同AKI分期作为HVHF治疗的时机,对比分析不同时期行HVHF治疗MODS患者的死亡率、平均重症监护病房(JCU)院时间(T1)、平均机械通气时间(T2)、平均连续血液滤过治疗时间(T3),并将HVHF治疗前和治疗24h后的APACHEⅡ评分、SOFA评分、血浆白介素-6(IL-6)、氧合指数、血浆肌酐(Cr)、平均动脉压(MAP)等结果进行比较。结果:1、AKIⅢ期患者死亡率显著高于AKⅡ期和AKIⅡ期患者(P<0.01);AKIⅡ期患者T1、T2和T3显著高于AKIⅠ期患者(P<0.01);2、与AKIⅠ期和AKIⅡ期患者比较,AKIⅢ期患者HVHF治疗前APACHEⅡ评分、SOFA评分、IL-6和Cr均显著增高(P<0.05);AKIⅡ期患者HVHF治疗前血浆IL-6显著高于AKIⅠ期患者(P<0.01);3、与HVHF治疗前比较,三组患者HVHF治疗24 h后IL-6、氧合指数、Cr和MAP均显著改善(P<0.01);AKIⅢ期患者治疗后的IL-6仍显著高于AKIⅠ期和AKIⅡ期患者;AKIⅠ期和AKIⅡ期患者HVHF治疗24h后APACHEⅡ评分、SOFA评分显著降低(P<0.01),AKIⅢ期患者治疗前后APACHEⅡ评分和SOFA评分变化无显著统计学差异。结论:RIFLE标准及IL-6对判断预后有指导意义;AKIⅠ期和Ⅱ期行HVHF可明显改善MODS的预后,而AKI I期行HVHF的疗效更好。     

1-Chloro-2-formyl indenes and tetralenes as antitubercular agents

1-Chloro-2-formyl indenes and tetralenes have been synthesized using Vilsmeier-Haack-Arnold reaction onto indanones and tetralones. Most of these analogues exhibited antitubercular activity against Mycobacterium tuberculosis H37Rv strain with MICs ranging from 30 to 500 μg/mL. Analogue 13 was further modified to some derivatives. The most active analogue 23 showing MIC at 30 μg/mL was further evaluated for acute oral toxicity in Swiss albino mice and was found to be safe up to 300 mg/kg dose.     

SARS-CoV的分子生物学研究

SARS-CoV是引起严重急性呼吸道综合症(SARS)的病原体．更多地了解SARS-CoV的基因组、蛋白结构以及它与其它冠状病毒的关系,将有助于SARS疾病的防治．     

姜黄素预处理对干热环境下中暑大鼠肾组织NF-κB p65及炎症因子表达的影响

目的:探讨不同剂量姜黄素对沙漠干热环境下大鼠肾组织炎症因子及NF-κB p65表达的影响。方法:将50只SD大鼠随机(随机数字法)分为五组(n=10):常温对照组、干热对照组、姜黄素低浓度组(50 mg/kg)、姜黄素终浓度组(100 mg/kg)、姜黄素高浓度组(200 mg/kg)。常温对照组及干热对照组均给予0.9%生理盐水灌胃,姜黄素组大鼠给予不同浓度姜黄素溶液灌胃,连续7天。在干热环境中放置150分钟后,麻醉处死大鼠,留取血液、肾组织进行分析。观察各组大鼠肾组织形态,检测肾组织中IL-1β、IL-6、TNF-α以及NF-κB p65表达及血清肌酐、尿素氮以及尿液中肾损伤分子1(KIM-1)、中性粒细胞明胶酶相关载脂蛋白(NGAL)的水平。结果:干热对照组大鼠血清肌酐、尿素以及尿液中KIM-1、NGAL水平均较常温对照组明显升高(P0.05),不同浓度姜黄素预处理组大鼠血清肌酐、尿素以及尿液中KIM-1、NGAL均较干热对照组有所下降,且差异具有统计学意义(P0.05)。干热对照组大鼠肾组织中IL-1β、IL-6、TNF-α以及NF-κB p65、磷酸化IκB-α的表达较常温对照组显著增加(P0.05)。姜黄素处理组大鼠随着姜黄素浓度的升高各指标较干热对照组呈不同程度的下降趋势(P0.05)。结论:姜黄素对于干热环境下大鼠肾损伤的保护作用,可能是与抑制NF-κB的表达降低细胞炎症反应水平有关。     

人心型脂肪酸结合蛋白(H-FABP)的原核表达、纯化和冻干品的制备

目的：获得重组人心型脂肪酸结合蛋白,分析其活性及制备冻干品。方法：从GenBank中检索人源H-FABP CDs 序列,合成基因后构建原核表达载体pET-28a（+）-H-FABP。将表达载体转入E.coli BL21（DE3）,摸索pET-28a（+）-H-FABP最佳诱导条件,表达并纯化重组蛋白。使用检测试剂检测纯化后的重组H-FABP活性,研究最佳冻干方案并考察冻干品的稳定性。结果：经过优化诱导条件,重组H-FABP在BL21（DE3）中以可溶性蛋白形式表达。诱导条件为OD₆₀₀≈0.6,IPTG终浓度0.4mmol/L,30℃诱导4h。通过Ni²⁺亲和层析纯化可得到纯度大于95%的重组H-FABP蛋白。重组H-FABP冻干品可以在37℃稳定保存12d,25℃、4℃稳定保存至少4个月。结论：本项研究中的重组H-FABP表达体系成熟、蛋白活性高,冻干品稳定性好,为后续研究提供了稳定高效的生物原材料。     

Percutaneous occlusion of post-myocardial infarction ventricular septum rupture

Aims

The aim of this systematic review is to gain insight into the published experience on percutaneous closure of a post-infarction ventricular septal rupture (VSR).

Method

Relevant literature was obtained by MeSH-term searches in the online search-engine PubMed. Articles published in the last 10 years were included. Further filtering was done by using search limits and individual article selection based on the aims of this systematic review.

Conclusion

Percutaneous closure is a potential technique in a select group of patients. The presence of cardiogenic shock and closure in the acute phase after VSR diagnosis are important risk factors of mortality. Device implantation is in general successful with few procedure-related complications. Reduction of the shunt fraction has been reported frequently. This technique is a less invasive alternative to surgical treatment and should be applied on a case-by-case basis.     

Current discharge management of acute coronary syndromes: data from the Rijnmond Collective Cardiology Research (CCR) study

Background

Medical discharge management of acute coronary syndromes (ACS) remains suboptimal outside randomised trials and constitutes an essential quality benchmark for ACS. We sought to evaluate the rates of key guideline-recommended pharmacological agents after ACS and characteristics associated with optimal treatment at discharge.

Methods

The Rijnmond Collective Cardiology Research (CCR) registry is an ongoing prospective, observational study in the Netherlands that aims to enrol 4000 patients with ACS. We examined discharge and 1-month follow-up medication use among the first 1000 patients enrolled in the CCR registry. Logistic regression was performed to identify patient and hospital characteristics associated with collective guideline-recommended pharmacotherapy at hospital discharge.

Results

At discharge, 94 % of patients received aspirin, 100 % thienopyridines, 80 % angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers, 87 % β-blockers, 96 % statins, and 65 % the combination of all 5 agents. ST-segment elevation myocardial infarction, hypertension, hypercholesterolaemia, and enrolment in an interventional centre were positive independent predictors of 5-drug combination therapy at discharge. Negative independent predictors were unstable angina and advanced age.

Conclusion

Current data from the CCR registry reflect a high quality of care for ACS discharge management in the Rotterdam-Rijnmond region. However, potential still remains for further optimisation.     

Development of quartz-crystal-microbalance-based immunosensor array for clinical immunophenotyping of acute leukemias

An integrated piezoelectric immunosensor array has been developed to immunophenotype acute leukemias in clinic. Each quartz crystal microbalance (QCM) was fabricated with plasma-polymerized film of n-butylamine, nanogold particles, and protein A (PA) to be used to immobilize antibodies in orientation. Leukemic lineage-associated monoclonal antibodies were separately immobilized onto the nanogold-PA-modified surface of the crystals, which were constructed by a 2 x 2 type of probes forming a QCM-based immunosensor array. The main detection conditions were investigated, including the immobilization amount of antibodies, pH, immunoreaction time, sample dilution ratio, etc. The immunophenotyping feasibility of the new technique was investigated through simultaneously analyzing Jurkat cells by the immunosensor array method, immunohistochemistry, and flow cytometry. It was found that the developed technique could readily identify leukemia samples in 5 min and might monitor dynamically the immunoreaction processes. Moreover, comparison studies were carried out for CD antigens expressed on the nucleated cells isolated from 96 acute leukemic patients and 24 normal subjects using the QCM-based immunosensor method and the fluoroimmunoassay. Results obtained by immunophenotyping patients' samples with the immunosensor-based method achieved the rate of 88.93% in 768 groups of numerical data, where no significant statistical difference was observed between the two methods when checked by chi2 analysis (chi2 = 3.4, p > 0.05). This new immunosensor array showed the merits of high sensitivity, high specificity, good reproducibility, easy operation, and low cost. The results of specimen evaluation indicated that it might be clinically suitable for quantifying human differentiated leukocytes and immunophenotyping of acute leukemias.