活化血小板检测在冠心病中的观察

目的　观察冠心病患者活化血小板的水平并了解其在不同类型冠心病中的意义。　 方法　选择稳定型心绞痛、不稳定型心绞痛及正常者各 2 0例。应用流式细胞技术 (CD62p)测定其活化血小板水平。其中有 2 2例行冠状动脉 (简称冠脉 )造影检查。　 结果 　冠心病不稳定型心绞痛CD62p水平为 (2 1 72± 7 5 ) % ,较稳定型心绞痛 (10 2 2± 5 2 ) %明显升高 ,且较正常组 (5 82± 2 5 ) %高 ,3者比较有统计学显著差异 (前 2者比较P <0 0 1,后 2者比较P <0 0 5 )。且冠脉病变越重 ,CD62p水平越高。　 结论 　冠心病患者尤其是不稳定型心绞痛患者CD62p水平增高 ,对病情判断及治疗提供依据     

不稳定型心绞痛介入治疗前后C反应蛋白的变化

目的　观察C 反应蛋白在不稳定型心绞痛患者行经皮冠状动脉介入治疗术前后的变化 ,探讨C 反应蛋白对冠心病预后的影响。方法　选择经皮冠状动脉成形术及支架植入术患者 2 0例及同期仅行冠状动脉造影术患者 30例。在行冠状动脉造影术或经皮冠状动脉介入治疗术前 12h及术后 12h分别采静脉血 2mL ,采用透射比浊法 ,应用日立自动分析仪测C反应蛋白。结果　行经皮冠状动脉介入治疗术组患者术前C反应蛋白为 5 .8± 0 .3mg L ,术后为18.5± 1.2mg L ,与术前比较差异具有显著性意义 (P <0 .0 5 ) ;仅行冠状动脉造影术的患者术前C反应蛋白为 4 .3±0 .5mg L ,术后为 4 .5± 0 .6mg L ,与术前比较差异无显著性意义 (P >0 .0 5 )。另两组病人同期的C反应蛋白比较差异有显著性意义 (P <0 .0 5 )。结论　经皮冠状动脉介入治疗术后C 反应蛋白增高与内皮损伤、斑块破裂、局部炎症反应密切相关 ;且C 反应蛋白可能与介入治疗术后再狭窄相关。因此C 反应蛋白可作为临床评估冠心病预后的独立危险因素。     

肌钙蛋白Ⅰ对老年不稳定性心绞痛患者危险分层的判断价值

目的　探讨心脏肌钙蛋白I(cTnI)对老年不稳定性心绞痛 (UAP)患者危险分层的判断价值。　方法　对 6 8例老年UAP患者、17例稳定性心绞痛 (SAP)患者及 11例健康对照者分别进行血清cTnI测定 ,并观察住院 1个月内心脏事件发生情况。　结果　UAP组血清cTnI值为 (1 94± 0 6 3)μg/L ,明显高于SAP组的 (0 6 1± 0 11) μg/L及对照组的 (0 47± 0 0 8) μg/L(均为P <0 0 1)。UAP组内 ,随着Braunwald临床分级增高 ,Ⅰ～Ⅲ级血清cTnI值相应增高〔分别为 (1 35± 0 2 8)、(2 0 4± 0 31)及(3 17± 0 74) μg/L〕(P <0 0 5 )。对照组、SAP组及BraunwaldⅠ级UAP患者无 1例发生心脏事件 ;BraunwaldⅡ级 1例患者发生非致命性心肌梗死 ;BraunwaldⅢ级患者中 ,血清cTnI≥ 1 5 μg/L者心脏事件发生率为 42 1% ,高于血清cTnI <1 5 μg/L者的 13 3% (P <0 0 5 ) ,比数比 (OR) 3 15 ,95 %可信限为1 0 1～ 9 81。血清cTnI≥ 1 5 μg/L时判断心脏事件的阳性预测值为 42 1% ,阴性预测值为 86 7%。　结论　血清cTnI检测对老年UAP患者危险分层有较好的判断价值。     

不稳定型心绞痛与PAI-1及血小板活性的临床研究

目的　探讨老年不稳定型心绞痛 (UAP)与纤溶酶原激活物抑制剂 1型 (PAI 1)及血小板活化功能的临床意义。　 方法 　测定 87例老年UAP患者发作时的血清PAI 1水平与血小板活化因子CD62p活性 ,并与 89例健康对照组比较。　 结果　UAP组的PAI 1的水平 (99.77± 3 2 .95 ) μg·L-1较对照组 (5 5 .0 0± 2 1.2 3 ) μg·L-1明显升高 (P <0 .0 1) ;而CD62p活性 (12 .5 6± 4.66) %较对照组 (6.3 3± 2 .3 8) %也有显著升高 (P <0 .0 1)。　 结论 　老年不稳定型心绞痛的发作与PAI 1水平和血小板活性增高有密切联系。     

肌钙蛋白I对无ST段抬高的急性冠状动脉综合征患者危险分层的判断

目的 :探讨血清肌钙蛋白I(cTnI)对无ST段抬高的急性冠状动脉综合征 (NSTEACS)患者危险分层的判断价值。方法 :对 4 2例NSTEACS患者、16例健康者分别进行血清cTnI测定 ,并观察住院 1个月内心脏事件发生情况。结果 :NSTEACS组血清cTnI值为 (1.98± 0 .11) μg/L ,明显高于正常对照组的 (0 .4 9± 0 .10 ) μg/L ,P <0 .0 1。NSTEACS组内 ,心肌梗死者 (cTnI阳性亚组 )血清cTnI值为 (2 .85± 0 .6 7) μg/L ,明显高于不稳定型心绞痛者 (cTnI阴性亚组 )的 (0 .73± 0 .16 ) μg/L ,P <0 .0 1。正常对照组无一例发生心脏事件 ;cTnI阳性亚组心脏事件发生率为 2 0 .8% ,高于cTnI阴性亚组的 5 .5 % (P <0 .0 5 ) ,比数比 (OR) 3.78,95 %可信度为 1.0 4～ 9.87。血清cTnI≥ 1.5 μg/L时判断心脏事件的阳性预测值为2 0 .8% ,阴性预测值为 94 .5 %。结论 :血清cTnI检测对NSTEACS患者危险分层有较好的判断价值     

血清基质金属蛋白酶9在介入治疗后心肌微梗死及支架内再狭窄中的预测价值

基质金属蛋白酶(MMPs)能特异地降解细胞外基质,在组织重构、斑块稳定性和再狭窄的病理发生中起重要作用。支架置入会造成血管损伤和管壁重构,置入处血管组织中MMP 2 ,MMP 9表达明显增加[1] 。我们对稳定型心绞痛患者介入治疗后,外周血MMP 9及金属蛋白酶抑制剂 1(TIMP 1)水平的改变与心肌微梗死以及远期支架内再狭窄间的关系进行了前瞻性研究。资料与方法1.研究对象:连续5 1例(男36例,女15例)在我院成功进行冠状动脉介入治疗的稳定型心绞痛患者,平均年龄(6 4±11)岁;行经皮冠状动脉腔内成形术(PTCA) 支架置入术治疗。均排除术…     

冠状动脉介入治疗对冠心病患者肌钙蛋白I及血管性血友病因子的影响

目的研究冠状动脉支架植入术对冠心病患者血中心肌肌钙蛋白I(cTnI)及血管性血友病因子(vWF)水平的影响。方法选择冠状动脉支架植入术患者110例为试验组;20例冠状动脉造影结果阳性,但未能进行介入治疗的患者作为对照组。术前和术后24 h检测cTnI和vWF。结果试验组术前和术后的cTnI值分别为(0.04±0.03)μg/L和(0.10±0.04)μg/L,两者比较差异有统计学意义(P<0.05),而对照组术前和术后的cTnI值比较差异无统计学意义(P>0.05)。试验组术前和术后的vWF水平分别为(123.75±32.77)%和(175.35±36.90)%,两者比较差异有统计学意义(P<0.05)。对照组vWF水平手术前后比较,差异无统计学意义(P>0.05)。而术后vWF水平及cTnI值试验组高于对照组,两组比较差异有统计学意义(P<0.05)。试验组术后cTnI与vWF呈线性相关(r=0.80,P<0.05)。结论冠状动脉支架植入术后血cTnI和vWF值升高,提示有心肌的微小损伤及血管内皮损伤的存在。     

经皮冠状动脉介入术对冠心病患者的QT离散度心率变异性和心室晚电位的影响

目的 :探讨冠心病患者经皮冠状动脉介入术 (PCI)治疗后 ,QT离散度 (QTd)、心率变异性 (HRV)及心室晚电位 (VLP)的变化 ,从而估计PCI对冠心病患者预后的影响。方法 :选择 2 0 0 1年 1月～ 2 0 0 2年 1月入院的经冠状动脉造影证实适合PCI的患者 6 0例 ,其中心绞痛组 39例和心肌梗死组 2 1例。在术前第 3天及术后第3天和术后 1个月分别测QTd、HRV和VLP。所获得的数据应用SPSS 10 .0软件分析系统进行分析。结果 :PCI术前 [(4 0 .4 6± 14 .85 )ms]和术后 [(2 8.96± 11.4 2 )、(2 7.85± 9.6 6 )ms]的QTd比较差异有显著性意义 (P <0 .0 1) ,而术后第 3天和术后 1个月的QTd差异无显著性意义 (P >0 .0 5 )。HRV和VLP :PCI术前第 3天[(7.5 3± 7.0 5 )、2 1.6 7% ]、术后第 3天 [(8.2 5± 7.0 3)、2 3.33% ]和术后 1个月 [(7.81± 7.5 2 )、18.33% ]相比差异无显著性意义 (P >0 .0 5 )。结论 :成功的PCI使缺血的心肌重新获得充足的血供 ,QTd缩短 ,但PCI对心率变异性和心室晚电位的改善并不明显。     

阿替洛尔和曲美他嗪联用治疗稳定型心绞痛疗效观察

近年来 ,我们应用阿替洛尔、曲美他嗪治疗稳定型心绞痛患者 33例 ,取得较好疗效。现报告如下。资料与方法 :本组 33例患者均为男性 ,年龄平均 (5 6± 6 )岁 ;心绞痛病程平均 (2 8.8± 4 .4 )个月。既往有心肌梗死病史16例 ,曾行冠状动脉旁路移植术 1例 ,经皮冠状动脉介入治疗 2例。患者每周心绞痛发作平均 (4.2± 0 .5 )次。符合加拿大心脏病学会制定的心绞痛分级 ～ 级。均经活动平板试验阳性及冠状动脉造影显示冠状动脉明显狭窄而诊断为稳定性心绞痛。方法 :阿替洛尔 12 .5 mg/次口服 ,2次 / d,连用 30天。曲美他嗪 2 0 m g/次口服 ,3次…     

不稳定型心绞痛患者血清尿酸水平增高

为探讨血清尿酸水平与冠状动脉粥样斑块稳定性之间的关系 ,检测 33例不稳定型心绞痛患者、2 4例稳定型心绞痛患者和 33例正常对照者外周血清尿酸水平 ,并进行对比分析。结果发现 ,不稳定型心绞痛患者血清尿酸水平 (40 3± 115mmol L)明显高于稳定型心绞痛患者 (32 0± 81mmol L)和对照者 (312± 6 7mmol L ,P <0 .0 1) ,而稳定型心绞痛患者与对照者相比无显著性差异。结果提示 ,血清尿酸水平与冠状动脉粥样斑块稳定性密切相关 ,有可能作为评价冠心病斑块稳定性的分子生物化学标志物。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Variabilité des concentrations plasmatiques de l’angiotensinogène et risque d’hypertension artérielle chez le rat transgénique

Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.