颈动脉内-中膜厚度对冠状动脉病变的预测价值

目的:探讨颈动脉内-中膜厚度对冠状动脉病变的预测价值。方法:根据冠状动脉造影结果,将183例行冠状动脉造影的患者分为3组:正常组59例为冠状动脉造影阴性;A组54例冠状动脉狭窄率50%;B组70例冠状动脉狭窄率≥50%。根据冠状动脉病变数量将124例冠状动脉狭窄的患者进一步分为单支病变组40例,双支病变组38例和多支病变组46例。所有患者行颈动脉超声检查,测量颈动脉内-中膜厚度。结果:A组、B组的颈动脉内-中膜厚度和冠脉积分(Gensini评分)均明显高于正常对照组,且B组颈动脉内-中膜厚度和Gensini评分均较A组明显增加,差异均有统计学意义(P0.05)。随着冠状动脉狭窄程度的加重,颈动脉内-中膜厚度和Gensini评分逐渐增加。多支病变组、双支病变组IMT值和Gensini评分均显著高于单支病变组(P0.05),而双支病变组与多支病变组比较差异均无统计学意义(P0.05)。颈动脉IMT厚度与冠状动脉病变数量相关性不大,与Gensini评分呈显著性正相关(P0.01)。结论:颈动脉内-中膜厚度能较好地预测冠状动脉病变程度,但不能预测冠状动脉病变范围。     

不同血压参数与原发性高血压伴微量白蛋白尿的相关性分析

目的:分析不同血压参数与原发性高血压(EH)伴微量白蛋白尿(MAU)的相关性。方法:选取51例EH合并MAU患者作为MAU组,选取同期51例EH未合并MAU患者作为NMAU组,对两组患者的一般临床资料、血液生化指标、血压相关指标及其相关性进行比较和分析。结果:NMAU组患者的诊室血压分级显著低于MAU组(P0.05),两组患者除昼间舒张压外的各项血压相关指标的差异均有统计学意义(P0.05)。多元线性回归结果显示:患者的MAU水平与中心动脉收缩压(β=0.306)、中心动脉脉压(β=0.215)、臂踝动脉脉搏波传导速度(β=0.163)呈正相关关系(P0.05),与夜间平均动脉压下降率(β=-0.191)呈负相关有关系(P0.05)。结论:EH伴发MAU患者主要表现为血压水平的显著升高,特别是中心和肢端收缩压、脉压的升高和昼夜血压节律性的缺失,上述血压变化促进了MAU的发病和进展,血压参数可作为预测EH患者伴发MAU发病和进展的辅助指标。     

硝苯地平联合缬沙坦治疗老年原发性高血压疗效分析

目的:探讨硝苯地平缓释片联合缬沙坦治疗老年原发性高血压的临床疗效。方法:将180例患者随机分入对照组与观察组,给予对照组86例患者硝苯地平缓释片口服降压;观察组94例患者接受硝苯地平缓释片联合缬沙坦治疗,比较两组患者治疗8周后血压、心率、脉压、肾功、尿酸、血钾及尿微量白蛋白的变化。结果:治疗后观察组患者收缩压、舒张压、脉压及心率均显著降低,治疗总有效率高于对照组,两组比较差异有统计学意义(P<0.01);观察组尿酸、尿微量白蛋白显著优于对照组(P<0.01),两组肾功、血钾比较差异无统计学意义(P>0.05)。结论:硝苯地平缓释片联合缬沙坦治疗老年原发性高血压,降压平稳,同时可显著降低尿酸及尿微量白蛋白,改善肾功能。     

血生长停滞特异性蛋白6、胱抑素C与老年2型糖尿病肾病相关性的研究

目的:探讨生物学标志物血生长停滞特异性蛋白6(Growth arrest specific protein 6,Gas6)、胱抑素C(Cystatin C,Cys-C)与老年2型糖尿病肾病的相关性。方法:于2014年4月-2015年4月期间在上海交通大学医学院附属仁济医院(南院)接受治疗的患者中,选取130例年龄≥60岁的老年2型糖尿病患者为研究组,其中根据有无微量白蛋白尿,将上述患者分为60例尿微量白蛋白阴性组和70例尿微量白蛋白阳性组,同时选取医院体检显示健康的65例年龄≥60岁的正常人为对照组,观察比较三组的血Gas6、血Cys-C水平指标。结果:研究组中两亚组的血Gas6水平均明显低于对照组,差异有统计学意义(P0.05);尿微量白蛋白阳性组的血Gas6水平明显低于尿微量白蛋白阴性组,差异有统计学意义(P0.05);研究组中两亚组的血Cys-C水平均高于对照组,差异有统计学意义(P0.05);尿微量白蛋白阳性组的血Cys-C水平明显高于尿微量白蛋白阴性组,差异有统计学意义(P0.05)。结论:老年2型糖尿病肾病的发生及发展与血Gas6、血Cys-C水平有关,血Gas6水平的下降,血Cys-C水平的升高,提示糖尿病的肾脏损伤程度加重,对早期2型糖尿病肾病的诊断具有一定的预测价值。     

原发性高血压患者血压昼夜节律与靶器官损害的关系研究

目的:研究原发性高血压患者血压昼夜节律异常是否与靶器官损害存在关联。方法:将2015年2~11月份在我院治疗的94例原发性高血压病人按照血压昼夜节律是否正常分为节律正常组52例和异常组42例。比较两组患者的24h、白天、夜间的收缩压(SBP)与舒张压(DBP)及血压负荷,并且比较两组患者心脏、脑、肾损伤相关指标。结果:异常组全天24h、白天、夜间SBP及DBP,血压负荷均高于正常组,差异具有统计学意义(P0.05)。异常组患者左室重量(LVM)和左室重量指数(LVMI)、发生心肌缺血次数及持续时间、发生脑梗死几率均明显高于正常组,差异有统计学意义(P0.05)。异常组尿微量白蛋白(MAU)、尿酸(UA)水平均高于正常组,差异有统计学意义(P0.05)。结论:原发性高血压患者出现昼夜节律异常,可能对相关靶器官造成损伤。     

幽门螺杆菌感染对冠心病患者冠状动脉病变程度与血清Ghrelin/obestatin比值的影响

目的探讨幽门螺杆菌(Helicobacter pylori,H.pylori)感染与冠心病患者冠状动脉病变程度和血清Ghrelin/obestatin比值之间的关系。方法选取2013年1月至2014年10月行冠状动脉造影确诊冠心病患者116例作为冠心病组,选取同期健康体检人员80例作为对照组。对所有患者的冠状动脉病变程度进行Gensini评分,运用14 C尿素呼气试验方法测定H.pylori感染情况,测定血清Ghrelin和obestatin水平,分析H.pylori感染与冠状动脉病变程度、血清Ghrelin/obestatin比值之间的关系。结果冠心病组H.pylori感染阳性率明显高于对照组,差异有统计学意义(P0.05)。H.pylori感染阳性组Gensini积分明显高于H.pylori感染阴性组,差异有统计学意义(P0.05);H.pylori感染阳性组Ghrelin/obestatin比值明显低于H.pylori感染阴性组,差异有统计学意义(P0.05)。结论 H.pylori感染能够加重冠心病患者冠状动脉病变程度,引起Ghrelin/obestatin比值异常升降低。H.pylori感染与冠心病发生发展密切相关。     

尿微量蛋白与尿酶联合检测在早期肾脏损害诊断中的临床应用价值

目的:探讨尿微量蛋白与尿酶联合检测在早期肾脏损害诊断中的临床应用价值.方法:尿微量白蛋白( mALB)、视黄醇结合蛋白(RBP)采用免疫透射比浊法测定;尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)采用终点法测定,尿肌酐(Cr)采用肌氨酸氧化酶法测定.结果:①尿蛋白定性为阴性的高血压、糖尿病、系统性红斑狼疮患者(尿蛋白阴性组)尿mALB/Cr、RBP/Cr、NAG/Cr显著高于正常对照组,两组比较差异具有统计学意义(P均＜0.05).尿蛋白定性为阳性的高血压、糖尿病、系统性红斑狼疮患者(尿蛋白阳性组)尿mALB/Cr、RBP/Cr、NAG/Cr显著高于阴性组,两组比较差异具有统计学意义(P均＜0.05).②应用单个指标或任意两个指标联合诊断早期肾损害的灵敏度较低,应用3个指标联合诊断早期肾损害的灵敏度达到86.30％.结论:尿mALB、RBP、NAG联合检测可以早期、可靠地诊断肾脏损害.     

尿微量蛋白与尿酶联合检测在早期肾脏损害诊断中的临床应用价值

目的:探讨尿微量蛋白与尿酶联合检测在早期肾脏损害诊断中的临床应用价值。方法:尿微量白蛋白(mALB)、视黄醇结合蛋白(RBP)采用免疫透射比浊法测定;尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)采用终点法测定,尿肌酐(Cr)采用肌氨酸氧化酶法测定。结果:①尿蛋白定性为阴性的高血压、糖尿病、系统性红斑狼疮患者(尿蛋白阴性组)尿mALB/Cr、RBP/Cr、NAG/Cr显著高于正常对照组,两组比较差异具有统计学意义(P均<0.05)。尿蛋白定性为阳性的高血压、糖尿病、系统性红斑狼疮患者(尿蛋白阳性组)尿mALB/Cr、RBP/Cr、NAG/Cr显著高于阴性组,两组比较差异具有统计学意义(P均<0.05)。②应用单个指标或任意两个指标联合诊断早期肾损害的灵敏度较低,应用3个指标联合诊断早期肾损害的灵敏度达到86.30%。结论:尿mALB、RBP、NAG联合检测可以早期、可靠地诊断肾脏损害。     

血清CK-MB和FIB水平与急性心肌梗死患者的冠状动脉狭窄程度关联

为了研究急性心肌梗死患者血清CK-MB、FIB与冠状动脉狭窄程度的相关性。本研究选择116例行冠状动脉造影检查者分为急性心肌梗死组(n=81)、对照组(n=35;冠状动脉造影阴性者)。用Gensini积分评定冠状动脉狭窄程度,根据评分将患者分为4组:Ⅰ组(0～7分) 8例,Ⅱ组(8～25分) 15例,Ⅲ组(26～46分) 30例及Ⅳ组(46分) 28例。测定各组血清CK-MB、FIB水平,并进行比较。研究结果表明:对照组和急性心肌梗死组年龄、体重、身高、舒张压、收缩压、脉压、心律、吸烟率、血清总胆固醇(total cholesterol, TC)、甘油三酯(triglyceride, TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol, LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol, HDL-C)、左心室射血分数(left ventricular ejection fraction, LVEF)、左心室舒张末期容积(left ventricular end-diastolic volume, LVEDV)及左心室收缩末期容积(left ventricular endsystolic volume, LVESV)比较,差异无统计学意义(p0.05)。对照组和急性心肌梗死各组间Gensini评分具有显著性差异(p0.01)。对照组和Ⅰ、Ⅱ、Ⅲ、Ⅳ组之间血清CK-MB、FIB水平具有差异性,且有统计学意义(F=8.164, p0.017; F=6.351, p0.028)。对照组血清CK-MB与FIB水平与Gensini积分无相关性(r=0.13, p=0.35; r=0.19, p=0.27)。急性心肌梗死患者血清CK-MB与FIB水平和Gensini积分均呈正相关(r=0.66, p0.001; r=0.77, p0.001)。我们初步认为急性心肌梗死患者血清CK-MB和FIB水平显著升高,且与冠状动脉狭窄程度具有相关性。     

老年原发性高血压患者血压晨峰与早期肾损害的临床观察

目的:探讨老年原发性高血压患者血压晨峰与早期肾损害的关系。方法:选择我院收治的94例老年原发性高血压患者进行24小时动态血压监测,并根据监测结果,将患者分为晨峰组62例和非晨峰组32例,检测和比较两组的血肌酐和尿素氮、12小时尿微量蛋白、尿β2微球蛋白、空腹血糖、血脂等指标。结果:老年高血压患者晨峰组12小时尿微量蛋白、尿β2微球蛋白均显著高于非晨峰组(P0.05);晨峰血压与12小时尿微量白蛋白(r=0.374)、尿β2微球蛋白(r=0.456)呈显著正相关。结论:老年原发性高血压患者血压晨峰与早期肾损害有关,治疗高血压的同时重视控制晨峰血压有重要意义。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.