支链氨基酸与心血管疾病的关系及干预措施研究进展

大量研究证实支链氨基酸（branched-chain amino acids,BCAAs）在心血管疾病如冠心病、动脉粥样硬化、高血压等的发生和发展中起着重要作用,且宿主BCAAs水平的升高与饮食、肠道菌群、疾病和遗传等因素均密切相关。从因果关系上看,肠道菌群紊乱促进了心血管疾病的发生发展,且部分肠道微生物参与BCAAs的生物合成,直接影响宿主外周BCAAs水平。近年来,从宿主和肠道菌群的角度干预BCAA代谢已成为国内外防治心血管疾病的研究热点。现就BCAAs与心血管疾病关系和肠道菌群-BCAAs代谢途径干预方法的研究进展进行综述。     

肠道菌群-TMA-TMAO代谢途径与心血管疾病的研究进展

肠道菌群紊乱与心血管疾病的发生发展密切相关。肠道微生物利用富含胆碱或三甲胺(TMA)结构的物质代谢生成氧化三甲胺(TMAO),而TMAO在心血管疾病如冠心病、动脉粥样硬化、高血压等的发生和发展中起着重要作用。该文就TMAO与心血管疾病关系和肠道菌群-TMA-TMAO代谢途径干预方法的研究进展进行综述。     

新疆南部维吾尔族人群尿石症与血管内皮生长因子基因多态性关系的研究

目的 探讨新疆南部维吾尔族人群血管内皮生长因子(VEGF)-460位点基因多态性与泌尿系结石的关系.方法 应用聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)、基因测序等方法检测200例尿石症患者的VEGF-460基因多态性,200例健康人群体检标本作为对照组,比较2组VEGF-460基因型和等位基因的分布频率.结果 2组VEGF-460位点CC、TT、CT基因型和等位基因比较差异均无统计学意义(P＞0.05),基因型分布频率分别为1.5%、29.0%、69.5%和0.5%、27.5%、72.0%,等位基因C、T分别为36.2%、63.7%和36.9%、63.1%,2组比较差异均无统计学意义(P＞0.05).结果 新疆南部地区维吾尔族人群VEGF-460基因多态性与尿石症无关,VEGF-460位点可能不是维吾尔族尿石症的易感基因.     

肾周脂肪对肾细胞癌患者术后生存率的影响

目的评价肾周脂肪对肾细胞癌患者术后生存率的影响。方法回顾性分析116例因患肾细胞癌进行了肾部分切除术或根治性肾切除术患者的临床资料。结果肾周脂肪厚度和BMI呈正相关(r=0.926,P=0.000)。用Kaplan-Meier法对肾周脂肪厚度与预后的关系进行分析,结果表明肾周脂肪厚度<1.64 cm者总体生存率为40.52%±4.32%,肾周脂肪厚度≥1.64 cm者总体生存率为69.25%±4.91%(χ2=25.793,P=0.000)。多因素分析表明,在不考虑BMI的情况下,肾周脂肪厚度是肾细胞癌术后患者的独立预后因素(P=0.000)。结论在不考虑BMI的情况下,肾周脂肪厚度是肾细胞癌术后患者的独立预后因素,可以用来评估肾细胞癌术后患者的预后。     

饮食结构调整对预防泌尿系结石复发的影响

目的研究根据结石成分分析结果调整饮食结构与结石复发的关系。方法 290例泌尿系结石患者进行结石成分分析,并随机分为2组,一组根据结石成分分析结果调整饮食,另一组则按传统方法嘱患者多饮水等,不进行特别的饮食结构调整。观察2组的复发率。结果饮食结构调整组复发11例（7.5%）,对照组复发23例（16.1%）,饮食结构调整组结石复发率明显低于对照组（χ2=5.181,P=0.023）,差异有统计学意义。结论根据患者代谢及结石成分分析结果进行调整饮食结构,可有效预防泌尿系结石的复发。     

膀胱二聚体Cajal间质细胞的超微结构及其对ATP的电反应

目的:为证明膀胱二聚体Cajal间质细胞(interstitial cells of Cajal,ICC)发挥起搏作用提供超微结构和功能学证据。方法:电子显微镜下鉴定组织和培养的豚鼠膀胱二聚体ICC并观察ICC之间的超微联系;体外分离、培养豚鼠膀胱ICC,运用细胞膜片钳技术观察ATP(100μmol/L)刺激下二聚体ICC和单体ICC的兴奋性差别。结果:二聚体ICC中两个ICC细胞胞体紧密相连,细胞之间的间隙小于20 nm,存在大量缝隙连接,局部细胞膜融合,形成联胞体。在ATP(100μmol/L)的刺激下体外培养的二聚体ICC的内向电流幅度为286.9±26.4 pA,显著大于单体ICC的内向电流幅度163.8±18.6 pA(P<0.01)。结论:二聚体ICC具有形成高兴奋起搏电流的超微结构基础,高兴奋性的二聚体ICC可能才是逼尿肌的起搏细胞。     

胸腔镜纵隔肿物切除二例

例1:女,4岁3个月.患儿咳嗽,发热,有痰不能咳出,喘气费力3d入院.查胸片提示右上肺病变,CT提示右主支气管处纵隔支气管囊肿.增强CT:支气管隆突下方见囊性肿物影,约38mm×46mm大小(图1).查体:T37.9℃,R20次/min,双眼睑轻度水肿,双肺呼吸音粗,可闻及明显痰鸣音,三凹征,余无异常.     

肝前型门脉高压研究进展

小儿门脉高压是由门静脉系统的血流阻塞引起的,按照门静脉阻塞的部位,分为肝前型门脉高压、肝内型门脉高压和肝后型门脉高压.门脉高压一般指门静脉压力超过10～12 mmHg,小儿正常门脉压力很少超过7 mmHg.小儿肝前型门脉高压较多见,约占小儿门脉高压的33%～54%.     

胆道闭锁术中胆汁流量及胆汁成分的观察分析

Objective To assess the prognostic values of intraoperative bile flow and bile components in patients with biliary atresia. Methods The intrahepatic bile of 27 children with biliary atresia (BA) were collected intraoperatively. The bile collected from 17 children with choledochal cysts in surgery were studied as the control group. Bile flow was monitored in 7 cases. The concentrations of phospholipid, total protein (TP), bile acid (TBA), the total bilirubin (TBIL), direct bilirubin (DBIL),total cholesterol (TC), aspartate aminotransferase (AST), alanine aminotransferase ( ALT), γ- glutamine (GGT),alkaline phosphatase (ALP) in bile were measured. Patients with BA were followed for 1-6 months post-operatively. The information collected during the follow-up included the time when the jaundice disappeared,the blood biochemistry and onset of cholangitis. Results The bile flow of children with BA were significantly lower than that in the control group (P<0. 05). The bile flow of children with BA whose operative age > 60 days or preoperative blood ALT > 150 U/L were significantly lower than that in the control group (P<0. 05). The jaundice-relieving rate 2 months post-operatively in children with BA whose bile flow ≥0. 19 ml/min was significantly higher than that in patients whose bile flow <0. 19 ml/min (P<0. 05). The concentrations of phospholipid,TBA and DBIL in bile of children with BA were significantly lower than those in the control group (P<0. 05). The concentration of ALT in bile of patients with BA was significantly higher than that in the control group (P<0. 01 ). The concentrations of AST and TC in bile of children with BA whose jaundice have been relieved before the third month postoperatively were significantly lower than those in with persistent jaundice (P<0. 05). Conclusions The correlation between the intraoperative bile flow and the prognosis is significant in children with BA: the faster the bile flow, the better of prognosis. This suggested that the intraoperative bile flow can effectively predict the long-term prognosis of BA after Kasai operation. The change of bile components in bile of BA indicated that the hepatic function of BA is poor, the lower concentrations of phospholipid,TBA and DBIL in bile may be due to poor hepatic function. The correlations between the concentrations of AST and TC in bile and prognosis were significant:, the lower of the concentration of AST and TC, the better of prognosis.     

基于肠道菌群的中药改善胰岛素抵抗的作用机制研究进展

中医药的特色与优势促进了其治疗与胰岛素抵抗相关的慢性代谢性疾病如肥胖、糖尿病等的发展,但其尚不明确的作用机制极大限制了中药现代化、国际化和产业化。随着2代/3代基因测序技术的飞速发展,肠道菌群已成为中药作用机制研究的热点和新途径。为此,探讨肠道菌群及其代谢产物与胰岛素抵抗的关系,从中药复方、药对、单味药和活性成分不同角度系统分析中药通过调控肠道菌群改善胰岛素抵抗的研究进展,以期为阐释中药的作用机制提供研究思路与参考。