安立泽联合胰岛素治疗单独胰岛素降糖欠佳的高龄2型糖尿病患者临床观察

目的：观察安立泽应用于单独胰岛素治疗血糖控制欠佳的高龄2型糖尿病患者的疗效及安全性。方法：200例高龄2型糖尿病胰岛素降糖欠佳的患者（空腹血糖控制在7．8．13．9mmol／L范围内）,随机分成对照组和治疗组,对照组采用胰岛素加安慰剂治疗80例;治疗组120例,分为A、B、c三组,每组40例,A、B、c三组分别在继续应用胰岛素治疗的基础上加服安立泽4mg／d、5mg／d、6mg／d,疗程三个月。观测治疗组和对照组治疗前后FPG及PPG、HbAlC、BMI和胰岛素用量的改变及治疗的安全性。结果：对照组和治疗组治疗前的各指标无明显差异（P〉0．05）;A、B、c三组在治疗后1个月和3个月FPG、PPG、H1）A1C均有明显的下降（P〈0．05,P〈0．01）,而对照组治疗前后FIG、PPG、HbAlC略有下降,差异不明显（P〉0．05）;A、B、c三组胰岛素的用量及体重指数较治疗前均略有下降,三组间无显著性差异;对照组和治疗组的不良反应发生率无显著差异。结论：对高龄2型糖尿病单用胰岛素治疗血糖控制欠佳的患者,加用安立泽治疗,可使糖尿病相关指标得以良好的控制,减少糖尿病患者每日胰岛素用量,临床毒副作用较小。     

Responsive microsecond-lifetime photoluminescent probes for analysis of protein kinases and their inhibitors

Responsive ARC-Lum probes were used for measurement of the concentration of active protein kinases (PKs) and determination of affinity of inhibitors of PKs. ARC-Lum probes incorporate thiophene or a selenophene heterocycle and a fluorophore conjugated to the lysine residue in the peptide fragment. In the complex with a PK, ARC-Lum probes emit long-lifetime (microsecond-scale) luminescence at the emission wavelengths of the fluorescent label if the complex is illuminated at the excitation wavelength of the thiophene- or selenophene-containing phosphorescence donors. Bisubstrate ARC-Lum probes bind with sub-nanomolar affinity with several PKs of the AGC group. This article is part of a Special Issue entitled: Inhibitors of Protein Kinases (2012).     

发热伴血小板减少综合征患者血清中核蛋白抗体的动态变化

目的:观察新发传染病发热伴血小板减少综合征(SFTS)的病原体新型布尼亚病毒(SFTSV)核蛋白(NP)IgM和IgG型抗体在SFTS患者外周血中的变化规律,为疾病的早期诊断和发病机制的认识提供依据.方法:用ELISA方法检测28例SFTS患者不同病程阶段血清中NP特异性IgM、IgG抗体.结果:①28例SFTS患者中,IgM阳性检出率为89.3 ％(25/28),IgG阳性检出率为85.7 ％(24/28).②IgM和IgG均在发病5天后开始出现,随着病程延长血清中抗体水平逐渐上升,其峰值出现在发病2周左右.③死亡组患者的抗体检出时间迟于痊愈组患者,且抗体水平低下.结论:①在SFTSV感染早期,SFTS患者血清中NP特异性抗体IgG和IgM的变化趋势一致,NP特异性抗体IgG和IgM一样是SFTS早期诊断的重要指标.②因疾病严重而死亡的患者,抗体出现延迟、抗体水平低下可能与患者细胞免疫系统严重受损及多脏器功能障碍有关,致使机体体液免疫应答减退或应答无能.③抗体出现延迟且抗体水平低下可能是病情严重患者预后不良的预测指标.     

四种小鼠便秘模型建立方法的比较

目的i初步探讨四种小鼠便秘模型建模方法的效果。方法：40只小鼠随机分为正常对照组（8只）和实验组（32只）,实验组分别采用经口灌胃止泻剂复方地芬诺酯、禁水不禁食、经口灌胃胃粘膜保护剂硫糖铝及经口灌胃冰水四种方法建立小鼠便秘模型,处理后观察四种不同方法建立的小鼠便秘模型首粒黑便排便时间、2小时内排便粒数及排便重量的差异。结果：与正常对照组比较,灌胃复方地芬诺酯、禁水不禁食、硫糖铝及冰水法四种造模方法均可使小鼠首粒黑便排便时间显著延长、2小时内排便粒数及排便重量显著减少（P〈0．05）。但采用复方地芬诺酯、禁水不禁食法处理的小鼠较经口灌胃硫糖铝及经口灌胃冰水诱导的小鼠首粒黑便排便时间显著延长、2小时内排便粒数及排便重量亦显著减少（P〈0．01）。结论：采用复方地芬诺酯、禁水不禁食方法建立小鼠便秘模型更加简单、有效。     

Combined effects of global climate change and regional ecosystem drivers on an exploited marine food web

Changes in climate, in combination with intensive exploitation of marine resources, have caused large‐scale reorganizations in many of the world's marine ecosystems during the past decades. The Baltic Sea in Northern Europe is one of the systems most affected. In addition to being exposed to persistent eutrophication, intensive fishing, and one of the world's fastest rates of warming in the last two decades of the 20th century, accelerated climate change including atmospheric warming and changes in precipitation is projected for this region during the 21st century. Here, we used a new multimodel approach to project how the interaction of climate, nutrient loads, and cod fishing may affect the future of the open Central Baltic Sea food web. Regionally downscaled global climate scenarios were, in combination with three nutrient load scenarios, used to drive an ensemble of three regional biogeochemical models (BGMs). An Ecopath with Ecosim food web model was then forced with the BGM results from different nutrient‐climate scenarios in combination with two different cod fishing scenarios. The results showed that regional management is likely to play a major role in determining the future of the Baltic Sea ecosystem. By the end of the 21st century, for example, the combination of intensive cod fishing and high nutrient loads projected a strongly eutrophicated and sprat‐dominated ecosystem, whereas low cod fishing in combination with low nutrient loads resulted in a cod‐dominated ecosystem with eutrophication levels close to present. Also, nonlinearities were observed in the sensitivity of different trophic groups to nutrient loads or fishing depending on the combination of the two. Finally, many climate variables and species biomasses were projected to levels unseen in the past. Hence, the risk for ecological surprises needs to be addressed, particularly when the results are discussed in the ecosystem‐based management context.     

A conserved START domain coenzyme Q-binding polypeptide is required for efficient Q biosynthesis,respiratory electron transport,and antioxidant function in Saccharomyces cerevisiae

Coenzyme Q_n (ubiquinone or Q_n) is a redox active lipid composed of a fully substituted benzoquinone ring and a polyisoprenoid tail of n isoprene units. Saccharomyces cerevisiae coq1–coq9 mutants have defects in Q biosynthesis, lack Q₆, are respiratory defective, and sensitive to stress imposed by polyunsaturated fatty acids. The hallmark phenotype of the Q-less yeast coq mutants is that respiration in isolated mitochondria can be rescued by the addition of Q₂, a soluble Q analog. Yeast coq10 mutants share each of these phenotypes, with the surprising exception that they continue to produce Q₆. Structure determination of the Caulobacter crescentus Coq10 homolog (CC1736) revealed a steroidogenic acute regulatory protein-related lipid transfer (START) domain, a hydrophobic tunnel known to bind specific lipids in other START domain family members. Here we show that purified CC1736 binds Q₂, Q₃, Q₁₀, or demethoxy-Q₃ in an equimolar ratio, but fails to bind 3-farnesyl-4-hydroxybenzoic acid, a farnesylated analog of an early Q-intermediate. Over-expression of C. crescentus CC1736 or COQ8 restores respiratory electron transport and antioxidant function of Q₆ in the yeast coq10 null mutant. Studies with stable isotope ring precursors of Q reveal that early Q-biosynthetic intermediates accumulate in the coq10 mutant and de novo Q-biosynthesis is less efficient than in the wild-type yeast or rescued coq10 mutant. The results suggest that the Coq10 polypeptide:Q (protein:ligand) complex may serve essential functions in facilitating de novo Q biosynthesis and in delivering newly synthesized Q to one or more complexes of the respiratory electron transport chain.     

Serogroup quantitation of multivalent polysaccharide and polysaccharide-conjugate meningococcal vaccines from China

The active components of most meningococcal vaccines are four antigenic serogroup capsular polysaccharides (A, C, Y, W135). The vaccines, monovalent or multivalent mixtures of either free polysaccharides or polysaccharides conjugated to antigenic carrier proteins, may be in liquid or lyophilised formulations, with or without excipients. Acid hydrolysis and chromatographic methods for serogroup quantitation, which were previously optimised and qualified using polysaccharide-based standards and a narrow range of real vaccines, are here challenged with multiple lots of a broad assortment of additional multivalent polysaccharide-based meningococcal vaccine products. Centrifugal filtration successfully removed all interfering lactose excipient without loss of polysaccharides to allow for the determination of Y and W135 serogroups. Replicate operations by three different analysts indicated high method reproducibility. Results indicated some lot-to-lot and product-to-product variations. However, all vaccines were within general specifications for each serogroup polysaccharide, with the exception of all lots of one polysaccharide vaccine – which by these methods were found to be deficient in the serogroup A component only. These robust techniques are very useful for the evaluation of antigen content and consistency of manufacture. The deformulation, hydrolysis and chromatographic methods may be adaptable for the evaluation of other types of polysaccharide-based vaccines.     

In Vitro and In Vivo Studies on Oxygen Free Radical and DNA Adduct Formation in Rat Lung and Liver during Benzo[a]pyrene Metabolism

Reactive oxygen species (ROS), possibly produced during the metabolic conversion of benzo(a)pyrene (B[a]P), could be involved in B[a]P-induced genotoxicity and, eventually, carcinogenicity. Therefore, ROS formation by rat lung and liver microsomes was studied in vitro by electron spin resonance (ESR/EPR) spectrometry. B[a]P-mediated generation of ROS was detected in incubations with rat lung, but not with liver microsomes. Inhibition of cytochrome P450 (CYP450) by the non isoform-specific inhibitor SKF-525A resulted in a complete inhibition of B[a]P-dependent ROS formation, whereas ROS formation was not affected by inhibition of prostaglandin H synthase by indomethacin. Subsequently, bulky DNA adduct formation and 8-oxo-dG levels after a single oral dose of B[a]P were examined in vivo in rat lung and liver, in combination with urinary excretion of 8-oxodG. B[a]P exposure resulted in increased urinary 8-oxo-dG levels. On the contrary, 8-oxo-dG levels decreased in liver and lung after B[a]P exposure. Bulky DNA adducts reached higher levels and were more persistent in rat lung than in liver. These results indicate that ROS are generated during the CYP450 dependent metabolism of B[a]P, particularly in the rat lung, but this does not necessarily result in increased levels of oxidative DNA damage in vivo, possibly by induction of DNA repair mechanisms.     

Cardiac resynchronisation therapy in patients with left bundle branch block with residual conduction

AimTo evaluate whether left bundle branch block with residual conduction (rLBBB) is associated with worse outcomes after cardiac resynchronisation therapy (CRT).MethodsAll consecutive CRT implants at our institution between 2006 and 2013 were identified from our local device registry. Pre- and post-implant patient specific data were extracted from clinical records.ResultsA total of 690 CRT implants were identified during the study period. Prior to CRT, 52.2% of patients had true left bundle branch block (LBBB), 19.1% a pacing-induced LBBB (pLBBB), 11.2% a rLBBB, 0.8% a right bundle branch block (RBBB), and 16.5% had a nonspecific intraventricular conduction delay (IVCD) electrocardiogram pattern. Mean age at implant was 67.5 years (standard deviation [SD] = 10.6), mean left ventricular ejection fraction (LV EF) was 25.7% (SD = 7.9%), and mean QRS duration was 158.4 ms (SD = 32 ms). After CRT, QRS duration was significantly reduced in the LBBB (p < 0.001), pLBBB (p < 0.001), rLBBB (p < 0.001), RBBB (p = 0.04), and IVCD groups (p = 0.03). LV EF significantly improved in the LBBB (p < 0.001), rLBBB (p = 0.002), and pLBBB (p < 0.001) groups, but the RBBB and IVCD groups showed no improvement. There was no significant difference in mortality between the LBBB and rLBBB groups. LV EF post-CRT, chronic kidney disease, hyperkalaemia, hypernatremia, and age at implant were significant predictors of mortality.ConclusionCRT in patients with rLBBB results in improved LV EF and similar mortality rates to CRT patients with complete LBBB. Predictors of mortality post-CRT include post-CRT LV EF, presence of CKD, hyperkalaemia, hypernatremia, and older age at implant.     

3D-printed patient-specific pelvis phantom for dosimetry measurements for prostate stereotactic radiotherapy with dominant intraprostatic lesion boost

AimDeveloping and assessing the feasibility of using a three-dimensional (3D) printed patient-specific anthropomorphic pelvis phantom for dose calculation and verification for stereotactic ablative radiation therapy (SABR) with dose escalation to the dominant intraprostatic lesions.Material and methodsA 3D-printed pelvis phantom, including bone-mimicking material, was fabricated based on the computed tomography (CT) images of a prostate cancer patient. To compare the extent to which patient and phantom body and bones overlapped, the similarity Dice coefficient was calculated. Modular cylindrical inserts were created to encapsulate radiochromic films and ionization chamber for absolute dosimetry measurements at the location of prostate and at the boost region. Gamma analysis evaluation with 2%/2mm criteria was performed to compare treatment planning system calculations and measured dose when delivering a 10 flattening filter free (FFF) SABR plan and a 10FFF boost SABR plan.ResultsDice coefficients of 0.98 and 0.91 were measured for body and bones, respectively, demonstrating agreement between patient and phantom outlines. For the boost plans the gamma analysis yielded 97.0% of pixels passing 2%/2mm criteria and these results were supported by the chamber average dose difference of 0.47 ± 0.03%. These results were further improved when overriding the bone relative electron density: 97.3% for the 2%/2mm gamma analysis, and 0.05 ± 0.03% for the ionization chamber average dose difference.ConclusionsThe modular patient-specific 3D-printed pelvis phantom has proven to be a highly attractive and versatile tool to validate prostate SABR boost plans using multiple detectors.