新活素与多巴酚丁胺治疗急性心力衰竭的疗效比较及对血浆Gal-3、CysC、ET-1水平的影响

目的:分析和比较新活素(Lrh-BNP)与多巴酚丁胺(Dob)治疗急性心力衰竭(AHF)的临床效果及对其血浆半乳糖凝集素(Gal)-3、胱抑素C(CysC)、内皮素(ET)-1水平的影响。方法:选取我院2015年2月~2017年2月收治的114例AHF患者,采用随机数字表法均分为两组。Dob组给予Dob治疗,Lrh-BNP组予以Lrh-BNP治疗。比较两组治疗前后心功能参数,血浆Gal-3、CysC、ET-1水平,临床综合疗效及不良反应的发生情况。结果:与治疗前相比,两组治疗72h后FS、LVEF值均显著升高(P0.01),LVEDD、血浆Gal-3、CysC、ET-1水平均显著降低(P0.01),且Lrh-BNP组以上指标较对照组改善更显著(P0.01)。治疗72h后,Lrh-BNP组总有效率为89.5%,较Dob组明显上升(73.7%,P0.05)。两组不良反应发生率相比差异无统计学意义(P0.05)。结论:与多巴酚丁胺相比,新活素治疗急性心力衰竭的疗效更好,安全性相当,可能与其有效降低患者血浆Gal-3、CysC、ET-1水平有关。     

骨髓间充质干细胞移植对急性肝功能衰竭大鼠肝组织miRNA-155和TNF-α表达的影响

目的探讨骨髓间充质干细胞（BMSCs）移植对急性肝功能衰竭（ALF）大鼠肝组织中miRNA-155和TNF-α表达的影响,以及与BMSCs疗效间的关系。方法将SD大鼠随机分为健康对照组、ALF组、BMSCs治疗组和BMSCs预防组,其中ALF组予以900 mg/kg D-GalN＋10μg/kg脂多糖腹腔注射建立模型;BMSCs治疗组在900 mg/kg D-GalN＋10μg/kg脂多糖腹腔注射后2 h,予以尾静脉注射BMSCs 5.0×10^6;BMSCs预防组在900 mg/kg D-GalN＋10μg/kg脂多糖腹腔注射前予以尾静脉注射BMSCs 5.0×10^6;健康对照组予以0.9﹪氯化钠溶液1 ml腹腔注射。给药7 h后每组处死大鼠,检测大鼠血清ALT和AST,ELISA法检测TNF-α水平,实时定量PCR检测肝组织miRNA-155、TNF-αmRNA。各组间肝功指标差异采用方差分析,同时观察每组大鼠的24 h生存率,并用卡方检验比较各组生存率的差异。结果 D-GalN/脂多糖诱导7 h后,与ALF组相比,BMSCs预防和BMSCs治疗组大鼠ALT、AST、TNF-α水平均有所降低（P〈0.01）;同时两组肝组织TNF-αmRNA和miRNA-155表达水平均有下调（P〈0.01）;但两组间相比较差异无统计学意义。ALF组大鼠肝组织miRNA-155上调和TNF-αmRNA诱导呈正相关（r=0.734,P=0.001）。BMSCs预防组和BMSCs治疗组miRNA-155和TNF-αmRNA的部分逆转亦呈正相关（r值分别为0.687和0.590,P值分别为0.004和0.006）。给药后24 h,健康对照组、ALF组、BMSCs治疗组和BMSCs预防组大鼠死亡率组间比较差异有统计学意义（c2=19.078,P〈0.01）。结论在BMSCs干预大鼠ALF发病过程中,可以部分逆转上调的肝组织miRNA-155和TNF-α,且存在协同性,提示BMSCs治疗ALF可能通过对肝组织miRNA-155和TNF-α的调控发生作用。     

利钠肽在急性心力衰竭预后评估及指导治疗中的作用

利钠肽(BNP与NT-proBNP)是预测急性心衰预后及评估急性心衰治疗效果可靠的指标.日常临床决策加用利钠肽检测提高了急性心衰高危患者的发现率,而这些患者往往需要加强追踪及强化治疗.现就利钠肽在评估急性心衰预后及指导心衰治疗中的价值作如下综述.     

A Case of Gene Fragmentation in Plant Mitochondria Fixed by the Selection of a Compensatory Restorer of Fertility-Like PPR Gene

The high mutational load of mitochondrial genomes combined with their uniparental inheritance and high polyploidy favors the maintenance of deleterious mutations within populations. How cells compose and adapt to the accumulation of disadvantageous mitochondrial alleles remains unclear. Most harmful changes are likely corrected by purifying selection, however, the intimate collaboration between mitochondria- and nuclear-encoded gene products offers theoretical potential for compensatory adaptive changes. In plants, cytoplasmic male sterilities are known examples of nucleo-mitochondrial coadaptation situations in which nuclear-encoded restorer of fertility (Rf) genes evolve to counteract the effect of mitochondria-encoded cytoplasmic male sterility (CMS) genes and restore fertility. Most cloned Rfs belong to a small monophyletic group, comprising 26 pentatricopeptide repeat genes in Arabidopsis, called Rf-like (RFL). In this analysis, we explored the functional diversity of RFL genes in Arabidopsis and found that the RFL8 gene is not related to CMS suppression but essential for plant embryo development. In vitro-rescued rfl8 plantlets are deficient in the production of the mitochondrial heme–lyase complex. A complete ensemble of molecular and genetic analyses allowed us to demonstrate that the RFL8 gene has been selected to permit the translation of the mitochondrial ccmF_N2 gene encoding a heme–lyase complex subunit which derives from the split of the ccmF_N gene, specifically in Brassicaceae plants. This study represents thus a clear case of nuclear compensation to a lineage-specific mitochondrial genomic rearrangement in plants and demonstrates that RFL genes can be selected in response to other mitochondrial deviancies than CMS suppression.     

严重急性呼吸综合征冠状病毒2型 IgM / IgG、病毒核酸和白细胞介素6的联合检测在2019冠状病毒病诊断和治疗中的价值

探讨严重急性呼吸综合征冠状病毒2型(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)免疫球蛋白M(Immunoglobulin M,IgM)/免疫球蛋白G(Immunoglobulin G,IgG)、病毒核酸和白细胞介素6(interleukin 6, IL-6)的联合检测在2019冠状病毒病(coronavirus disease 2019, COVID-19)诊断和治疗中的临床价值。本研究按照《新型冠状病毒肺炎诊疗方案(试行第七版)》的标准收集了93例确诊病例(51例危重型、18例重型,15例轻型和9例普通型)和20例疑似病例(核酸检测阴性但临床症状和CT检测结果均符合标准)。选取110例儿科、妇科、肿瘤、血液和消化等疾病患者并排除COVID-19作为对照组。采用全自动化学发光免疫分析技术和电化学发光技术检测所有研究对象血清中SARS-CoV-2 IgM/IgG和IL-6。用实时荧光定量反转录聚合酶链反应对病例组和对照组的咽拭子进行SARS-CoV-2核酸检测。结果发现,血清IgM、IgG和IL-6在疑似病例中的阳性率分别为85%、75%和0%,在确诊病例中的阳性率分别为98.9%、95.7%和75.2%(其中危重型分别为100%、100%和100%,重型分别为94.4%、100%和97.9%,轻型分别为100%、93.3%和5%、普通型分别为100%、66.7%和0%)。IL-6和 SARS-CoV-2 IgM/IgG表达水平的改变与患者疾病的严重程度存在一定的关联性,差异有统计学意义(χ²＝273.51,χ²＝149.37;P＜0.05)。血清IL-6和SARS-CoV-2 IgM/IgG的联合检测可作为诊断和治疗COVID-19的监测指标,也可作为SARS-CoV-2核酸检测假阴性的有效互补。     

空肠营养对重症急性胰腺炎的疗效观察

目的：探讨早期空肠营养对重症急性胰腺炎（SAP）的疗效。方法：118名重症急性胰腺炎患者随机分为EN组和TPN组．比较两组SAP病人住院时间、费用、感染率、并发症及死亡率等。结果：TPN组住院时间长,费用高,感染率、并发症及病死率高。差异具有显著性。结论：早期空肠营养支持可明显改善SAP病情,提高治疗效果。     

Deletion of MLIP (Muscle-enriched A-type Lamin-interacting Protein) Leads to Cardiac Hyperactivation of Akt/Mammalian Target of Rapamycin (mTOR) and Impaired Cardiac Adaptation

Aging and diseases generally result from tissue inability to maintain homeostasis through adaptation. The adult heart is particularly vulnerable to disequilibrium in homeostasis because its regenerative abilities are limited. Here, we report that MLIP (muscle enriched A-type lamin-interacting protein), a unique protein of unknown function, is required for proper cardiac adaptation. Mlip^−/− mice exhibited normal cardiac function despite myocardial metabolic abnormalities and cardiac-specific overactivation of Akt/mTOR pathways. Cardiac-specific MLIP overexpression led to an inhibition of Akt/mTOR, providing evidence of a direct impact of MLIP on these key signaling pathways. Mlip^−/− hearts showed an impaired capacity to adapt to stress (isoproterenol-induced hypertrophy), likely because of deregulated Akt/mTOR activity. Genome-wide association studies showed a genetic association between Mlip and early response to cardiac stress, supporting the role of MLIP in cardiac adaptation. Together, these results revealed that MLIP is required for normal myocardial adaptation to stress through integrated regulation of the Akt/mTOR pathways.     

Exploration of disease mechanism in acute kidney injury using a multiplex bead array assay: a nested case–control pilot study

Background: Acute kidney injury (AKI) following cardiac surgery with cardiopulmonary bypass (CPB) causes increased morbidity and mortality.

Objective: To evaluate the plasma profile of biomarkers potentially involved in AKI development following CPB.

Methods: In a nested case–control study, plasma levels of 27 biomarkers in 11 AKI cases were compared with 25 controls.

Results: Pre-CPB, plasma levels of epidermal growth factor and macrophage inflammatory protein-1β, 2?h following CPB, soluble vascular cell adhesion molecule-1 (sVCAM-1), fractalkine and macrophage inflammatory protein-1α, and at later time points, sVCAM-1 and interleukin-6 were associated with AKI.

Conclusion: Biomarkers associated with AKI following CPB may merit further study.     

Ⅱ期经皮输尿管镜治疗输尿管上段结石梗阻致孤立肾急性肾功能衰竭

目的:探讨经皮肾微造瘘术后Ⅱ期经皮输尿管镜治疗输尿管上段结石致孤立肾急性肾功能衰竭的安全性与有效性。方法:从2004年7月～2009年5月,利用经皮肾微造瘘建立经皮肾通道,引流1周后肾功能明显好转,再行经皮肾输尿管镜碎石治疗孤立肾输尿管上段结石。结果:16例患者中,所有患者均为单通道取石,结石清除率例(81.2%),未出现高热、出血等并发症。术后1月复查13例无结石残留。结论:微创经皮输尿管镜分期治疗输尿管上段结石致孤立肾急性肾功能衰竭是安全、有效的,同传统经皮肾镜相比,具有对病人创伤小,易恢复等优点。     

Autonomic control of heart rate is virtually independent of temperature but seems related to the neuroanatomy of the efferent vagal supply to the heart in the bullfrog, Lithobathes catesbeianus

Bullfrogs, Lithobathes catesbeianus, bearing a femoral artery cannula were held at 3 temperatures (10, 20 and 30 °C) for 24 h. Changes in heart rate were recorded before and after injection of cholinergic and adrenergic antagonists. Normal heart rate doubled for each temperature increment. Adrenergic tone on the heart varied around 20% at all 3 temperatures but cholinergic tone increased from −5% to 10% between 10 and 30 °C. In contrast, cholinergic tone increased from 75% at 5 °C to 329% at 25 °C in Xenopus laevis. Injection of the neural tracer True Blue into the cervical vagus of the bullfrog revealed a single location for vagal preganglionic neurons (VPN) in the dorsal vagal motor nucleus (DVN), while Xenopus had 30% of its VPN in a ventro-lateral group outside the DVN. Broader comparative studies have suggested that differences in the extent of vagal tone may relate to the location of VPN in the brainstem and this may be the case in these amphibians.