胃底黏膜组织Obestatin表达水平与肥胖症的关系

目的 了解不同体质量指教正常人群胃底黏膜组织Obestatin表达水平,探讨Obestatin在肥胖症中的可能作用机制.方法 于2010年10月-11月收集同济医院内镜中心行胃镜检查诊断结果正常的患者55例,依据不同体质量指数分为肥胖组、消瘦组和正常组,三组人群均在胃镜下取胃底黏膜一块,应用实时荧光定量PCR法测定Obestatin的相对含量,同时测量三组人群的体质量指数、腰围、臀围、腰臀比、收缩压、舒张压、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白,并进行分析比较.结果 (1)消瘦组,正常组和肥胖组三组比较,Obestatin差异有统计学意义(P＜0.05).(2) Obestatin和体质量指数、腰围、臀围以及空腹血糖水平呈显著负相关(r＜0.01),而和腰臀比、收缩压、舒张压、总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白无相关关系(r＞0.05).结论 Obestatin可能在肥胖症的发病机制中发挥一定的作用.     

Effect of partial liquid ventilation on lung function in oleic acid-induced lung injury model of piglets

Background Pediatric patients are susceptible to lung injury that does not respond to traditional therapies.Partial liquid ventilation （PLV） has been developed as an alternative ventilatory strategy for treating severe lung injury.The aim of this study is to investigate the effect of PLV on lung function in immature piglets.Methods Acute lung injury was induced in 12 Chinese immature piglets by oleic acid （OA）.The animals were randomly assigned to two groups （n=6 each group）：（1） conventional mechanical ventilation （MV） group and （2） PLV with FC-77 （10 ml/kg） group.Mean arterial blood pressure （MAP）,mean pulmonary arterial pressure （MPAP）,central venous pressure （CVP）,left atrial pressure （LAP）,systemic vascular resistance （SVR）,pulmonary vascular resistance （PVR）,cardiac output （CO）,mean pressure of airway （Paw）,dynamic lung compliance （Cydn）,and arterial blood gases were measured during the observation period.Results No piglet died in either group with severe lung injury.After four hours of ventilation,pH in the MV group gradually decreased to lower than 7.20,while in the PLV group,pH also gradually decreased but remained higher than 7.20 （P ＜0.05）.Partial pressure of oxygen in artery （PaO2） decreased in both groups,but with a significant difference between the PLV group and MV group （P ＜0.05）.Partial pressure of carbon dioxide in artery （PaCO2） increased in both groups,but with a significant difference between the PLV group and MV group （P ＜0.05）.Paw increased in both groups,but was not significantly different （P ＞0.05）.Cydn decreased in both groups,but without a significant difference （P ＞0.05）.At four hours,heart rate （HR） and MAP in both groups decreased.MPAP in both groups increased,and there was a significant difference between the two groups （P ＜0.05）.CVP was stable in both groups.At four hours,PVR and LAP were increased in both groups.CO was decreased in both groups （P ＜0.05）.SVR was stable during the observation time.Conclusion PLV did not improve outcome in changes of lung function.     

下丘脑中Ghrelin、Obestatin水平及其受体表达与糖尿病大鼠胃排空的关系

目的 探讨糖尿病大鼠下丘脑胃促生长素(Ghrelin)、肥胖抑素(Obestafin)水平及受体表达与胃排空的关系.方法 60只雄性Wistar大鼠随机等分为正常对照组、糖尿病组、胰岛素组.链脲佐菌素(STZ)造模,给药2周、6周后测胃排空及下丘脑Ghrelin、Obestatin、生长激素促分泌激素受体(GHSR)和孤儿蛋白受体39(GPR-39).结果 2周后,糖尿病和胰岛素组的胃排空率(%)(74±8、40±5)、Ghrelin(ng/g)(52±9、51±7)和Ghrelin/Obestatin(3.8±1.0、2.8±1.0)分别较正常组[32%±7%、(39±11)ng/g、2.1±0.8]高(均P＜0.05).糖尿病组Obestatin(ng/g)(14.2±2.0)较正常组(21.7±4.7)低(P＜0.05),而GHSR(1.26±0.46)较正常组(0.77±0.21)高(P＜0.05).胃排空率与Ghrelin、Ghrelin/Obestatin和GHSR/β-肌动蛋白(B-actin)正相关(r=0.49;r=0.63;r=0.73;P＜0.01),与Obestatin负相关(r=-0.74,P＜0.01).6周后,糖尿病和胰岛素组胃排空率(78.97%±8.13%.44.06%±5.06%)均较正常组(35.06%±3.91%)高(均P＜0.01).胃排空率与Ghrelin/Obestatin呈正相关(r=0.40,P＜0.05),未检测到GPR-39.结论 高血糖早期胃排空加速可能受Ghrelin和GHSR表达增加影响,而持续期受Ghrelin/Obestatin增大影响.     

Hydrogen sulfide defends against the cardiovascular risk of Nw-nitro-L-argininemethyl ester-induced hypertension in rats via the nitric oxide/endothelial nitric oxide synthase pathway

Background Dyslipidemia caused by liver injury is a significant risk factor for cardiovascular complications.Previous studies have shown that hydrogen sulfide （H2S） protects against multiple cardiovascular disease states in a similar manner as nitric oxide （NO）,and NO/endothelial nitric oxide synthase （eNOS） pathway is the key route of NO production.The purpose of this study was to investigate whether H2S can ameliorate the high blood pressure and plasma lipid profile in Nw-nitro-L-argininemethyl ester （L-NAME）-induced hypertensive rats by NO/eNOS pathway.Methods Thirty-six 4-week old Sprague-Dawley （SD） male rats were randomly assigned to 6 groups （n=6）：control group,L-NAME group,control ＋ glibenclamide group,control ＋ NaHS group,L-NAME ＋ NaHS group,and L-NAME ＋ NaHS ＋ glibenclamide group.Measurements were made of plasma triglycerides （TG）,low-density lipoprotein （LDL）,high-density lipoprotein （HDL）,total cholesterol （CHO）,glutamic-pyruvic transaminase （ALT） levels after 5 weeks.Then measurements of NO level and proteins expression of eNOS,P-eNOS,AKT,P-AKT were made in liver tissue.Results After 5 weeks of L-NAME treatment,the blood pressure,plasma TG （（1.22±0.12） mmol/L in L-NAME group vs.（0.68±0.09） mmol/L in control group; P ＜0.05） and LDL （（0.54±0.04） mmol/L in L-NAME group vs.（0.28±0.02） mmol/L in control group; P ＜0.05） concentration were significantly increased,and the plasma HDL （（0.26±0.02） mmol/L in L-NAME group vs.（0.69±0.07） mmol/L in control group; P ＜0.05） concentration significantly decreased.Meanwhile the rats treated with L-NAME exhibit dysfunctional eNOS,diminished NO levels （（1.36±0.09） mmol/g protein in L-NAME group vs.（2.34±0.06） mmol/g protein in control group; P ＜0.05） and pathological changes of the liver.H2S therapy can markedly decrease the blood pressure （（37.25±4.46） mmHg at the fifth week; P ＜0.05）,and ameliorate the plasma TG （（0.59±0.06） mmHg）,     

老年冠心病合并阻塞性睡眠呼吸暂停综合征患者ghrelin/obestatin比值的变化及意义

目的 探讨老年冠心病合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者胃饥饿素(ghrelin)/肥胖抑制素(obestatin)比值变化及临床意义。 方法 收集2014年1月-2015年12月在余姚市人民医院确诊的冠心病患者112例作为研究对象,根据是否合并OSAHS分为冠心病合并OSAHS组(48例)和单纯冠心病组(64例),选择同期健康志愿者40例作为对照组。采用ELISA法测定血清ghrelin、obestatin水平。根据冠脉造影结果采用Gensini积分评估冠脉病变程度,使用多导睡眠图(PSG)监测确诊OSAHS。 结果 冠心病合并OSAHS组、单纯冠心病组患者的ghrelin/obestatin比值显著低于对照组,差异均有统计学意义(P<0.05或P<0.01)。冠心病合并OSAHS组患者的Gensini积分明显高于单纯冠心病组,差异有统计学意义(P<0.05)。冠心病合并OSAHS组患者的ghrelin/obestatin比值与Gensini积分、AHI呈负相关。 结论 老年冠心病合并OSAHS患者的ghrelin/obestatin比值与冠状动脉病变程度密切相关。ghrelin/obestatin比值有可能作为预测老年冠心病合并OSAHS的预测指标之一。      

A preliminary study on correlation between adiponectin genotype polymorphisms and obstructive sleep apnea hypopnea syndrome

Background  Obstructive sleep apnea hypopnea syndrome (OSAHS) is regarded as a disease with strong genetic background and associated with hypoadiponectinemia. It is worthwhile to investigate the possible correlation between the single nucleotide polymorphisms (SNPs) in the adiponectin gene and OSAHS.

Methods  With the TaqMan polymerase chain reaction (PCR) method, the SNPs at positions 45 and 276 in the adiponectin gene were determined in Chinese of Han nationality in Nanjing district consisting of 103 OSAHS patients (OSAHS group) and 67 normal controls (control group). The association of adiponectin genotype polymorphisms at positions 45 and 276 with OSAHS was analyzed.

Results  No evidence of a direct association was found between OSAHS and adiponectin genotype SNP at positions 45 and 276 (P >0.05). However, compared with those OSAHS patients having G/T+T/T genotype at position 276, the OSAHS patients with G/G genotype showed a longer neck circumference, a prolonged duration of the longest apnea event, and an elevated level of blood cholesterol and low-density lipoprotein cholesterol (P <0.05).

Conclusions  No direct association was suggested between OSAHS and adiponectin genotype distribution at positions 45 and 276 in Chinese of Han nationality in Nanjing district. However, in OSAHS patients, those with adiponectin G/G genotype at position 276, seemed to have a higher potential risk in development of OSAHS than those having adiponectin SNP276 G/T +T/T genotype.

     

Changes of atrial natriuretic peptide and antidiuretic hormone in children with postural tachycardia syndrome and orthostatic hypertension: a case control study

Background The abnormal blood volume regulation is one of the most important pathogenesis in postural tachycardia syndrome in children.This study was designed to investigate the plasma atrial natriuretic peptide and antidiuretic hormone levels in postural tachycardia syndrome children,and their associations with the changes in heart rate and blood pressure in head-up test.Methods Twenty-one postural tachycardia syndrome patients （（12±2） years） and 26 healthy children （（12±1） years） were included.According to blood pressure changes in head-up test,the postural tachycardia syndrome patients were divided into two subgroups：postural tachycardia syndrome with orthostatic hypertension and postural tachycardia syndrome without orthostatic hypertension.The plasma atrial natriuretic peptide and antidiuretic hormone levels were measured using enzyme-linked immunosorbent assay.Results The plasma atrial natriuretic peptide level in postural tachycardia syndrome patients was higher than the control （P=0.004）,whereas the difference in plasma antidiuretic hormone level between postural tachycardia syndrome and controls was not significant （P=0.222）.The plasma antidiuretic hormone level of patients suffering from postural tachycardia syndrome with orthostatic hypertension was much higher than that of children having postural tachycardia syndrome without orthostatic hypertension （P ＜0.05）.In postural tachycardia syndrome patients,the updght max heart rate was positively correlated with the plasma atrial natriuretic peptide level （r=0.490,P＜0.05） and the upright systolic blood pressure was positively correlated with the plasma antidiuretic hormone levels （r=0.472,P ＜0.05）.Conclusions There was a disturbance of plasma atrial natriuretic peptide and antidiuretic hormone in postural tachycardia syndrome children.     

强化控制血糖、血压、血脂对2型糖尿病患者肥胖抑制素水平的影响及其与脂代谢的相关性

目的 观察强化控制血糖、血压、血脂对2型糖尿病患者肥胖抑制素水平的影响及其与脂代谢的相关性.方法 将72例2型糖尿病患者根据治疗方法不同分为4组:A组25例,强化血糖、血压控制;B组12例,A组基础上加用强化血脂治疗;C组20例和D组15例,在B组基础上分别加用维生素E和复方丹参滴丸治疗.结果 A组空腹血浆肥胖抑制素水平低于其他3组,差异有统计学意义(P＜0.01);空腹血浆肥胖抑制素浓度与体质量指数(BMI)、腰臀比(WHR)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FIN)和胰岛素抵抗指数(HOMA-IR)呈负相关(P均＜0.05),与HDL-C呈正相关(P＜0.05);逐步校正年龄、性别、BMI、WHR、血糖和血压后,较高水平的空腹血浆肥胖抑制素浓度与强化控制血脂相关(P＜0.01).结论 强化控制血脂较未强化控制血脂的2型糖尿病患者空腹血浆肥胖抑制素水平升高,肥胖抑制素可能与脂代谢相关.     

Urinary albumin excretion rate: a risk factor for retinal hard exudates in macular region in type 2 diabetic patients

Background The various risk factors for retinal hard exudates are still poorly understood in type 2 diabetic patients.The aim of this study was to determine the association between urinary albumin excretion rate （UAER） and hard exudates in macular region in north Chinese patients.Methods A total of 272 patients （272 eyes） were enrolled for this study,including 154 subjects from group 1 （mild hard exudates）,91 subjects from group 2 （moderate hard exudates） and 27 subjects from group 3 （severe hard exudates） confirmed using colour fundus photography,optical coherence tomography （OCT） as well as slit-lamp biomicroscopy with 78 diopter （D） lens.Each participant underwent a comprehensive assessment that included biochemical,clinical characteristics test and detailed ophthalmic evaluation.One-way analysis of variance （ANOVA） test and chi-square test were performed to analyze the fasting blood glucose （FBG）,glycated hemoglobin （HbA1c）,total cholesterol （TC）,low density lipoprotein （LDL）,high density lipoprotein （HDL）,triglycerides （TG）,full blood counts,urinary albumin excretion rate （UAER）,blood creatinine （CREA）,duration of diabetes,body mass index （BMI）,systolic blood pressures （SBP） and diastolic blood pressures （DBP） between groups.Ordinal logistic regression analysis was further performed in order to eliminating the possible confounding factors.Results Three groups were matched in terms of age and gender.Risk factors which showed significant difference between groups include FBG （P ＜0.001）,HbA1c （P ＜0.001）,LDL （P ＜0.001）,UAER （P ＜0.001）,duration of diabetes （P=0.001）,TC （P=0.005）,SBP （P=0.026）,CREA （P=0.004） and haemoglobin （Hb） （P=0.012）.There was no significant difference between groups for the TG,HDL,DBP,platelet,total white blood cells and BMI.Using ordinal Logistic regression analyses,of all the variables,HbA1c,LDL and UAER which were independent risk factor for hard exudates showed a si     

Evaluation of pelvic visceral functions after modified nerve-sparing radical hysterectomy

Background Nerve-sparing radical hysterectomy （NSRH） was developed in an attempt to minimize complications after radical hysterectomy.Since 2008,a modified NSRH-nerve plane-sparing radical hysterectomy （NPSRH） has been developed at the Cancer Hospital,Chinese Academy of Medical Sciences.The aim of this study was to investigate the role of NPSRH in improving postoperative pelvic visceral dysfunctions.Methods Eighty-three patients with International Federation of Gynecology and Obstetrics （FIGO） stage IB1-IIA2 cervical cancer received NPSRH （the study group） from January 2008 to October 2012.One hundred and sixty-six patients who underwent conventional radical hysterectomy （CRH） were randomly selected as the control group.Age,pathological type and stage were matched between the two groups.The safety of surgery was assessed by duration of operation and blood transfusion rate.Postoperative short-term bladder function was analyzed by duration of catheterization.Long-term bladder,anorectal and sexual function were evaluated with questionnaires.Results Seventy-eight patients （94.0%） in the NPSRH group and one hundred and sixty patients （96.4%） in the CRH group completed the study.Median follow-up time was 31.9 months and 31.0 months respectively （P=0.708）.There was no significant difference between the two groups in terms of age,body mass index,FIGO stage,pathologic type,preoperative and postoperative therapy （P 〉0.05）.The blood transfusion rate shared no difference between two groups （P=0.364）.The operation time in the NPSRH group was significantly longer than CRH group （P 〈0.01）.But the duration of catheterization and hospitalization in the NPSRH group was significantly reduced compared with CRH group （P 〈0.01）.In addition,the incidence of long-term urinary frequency,urinary incontinence,urinary retention,straining to void,constipation and diarrhea was significantly lower in the NPSRH group （P 〈0.05）.However,there was no significant difference regarding sexual function （P 〉0.05）.Conclusions The current evidence indicated that NPSRH improved long-term bladder function compared to CRH.Moreover,it may improve long-term anorectal function as well.     

Heliox as a driving gas to atomize inhaled drugs on acute exacerbation of chronic obstructive pulmonary disease: a prospective clinical study

Background Acute exacerbation of chronic obstructive pulmonary disease （AECOPD） is a common condition,which affects not only the quality of life of patients but also their prognosis.The purpose of this study was to explore the effects of an inhaled salbutamol sulfate solution and an inhalation suspension of the glucocorticoid budesonide that were atomized with heliox to treat patients with AECOPD.Methods Twenty-three patients with AECOPD were divided into a treatment group （He/O2=70％/30％） and a control group （N2/O2=70％/30％）.The salbutamol sulfate and budesonide were administered by inhalation twice a day for 7 days.Vital signs,arterial blood gas levels,pulmonary function and the levels of serum myostatin （sMSTN） were measured and lung vibration imaging was performed.Results We found that the PaO2 and PaCO2 values were not significantly different between the two groups at the various time points （P ＞0.05）.There were also no significant differences in any of the parameters of pulmonary function between the two groups.However,after baseline correction,the increase rate of the forced expiratory volume in one second （FEV1）,the forced vital capacity （FVC）,and the maximum minute ventilation （MW） appeared to be significantly increased at some time points compared with the baseline （before treatment） in both groups （P ＜0.05）.Although the values of quantitative lung distribution （QLD） for different regions and the levels of sMSTN were slightly different between the two groups,the repeated measures analysis of variance （ANOVA） revealed that there were no significant differences between the two groups or within any group （P ＞0.05）.Conclusion Although the use of heliox as a driving gas can improve symptoms and benefit patients with AECOPD,the heliox treatment group did not have significant differences in arterial blood gases,lung function,lung vibration response imaging or the levels of sMSTN compared with the control group.（Chinese Clinical Trial Register Center ChiCTR-TRC-00000273）     

Decreased hepatic glucose production in obese rats by dipeptidyl peptidase-IV inhibitor sitagliptin

Background  Dipeptidyl peptidase-IV (DPP-4) inhibitors are now used to improve postprandial glycemic control in type 2 diabetes. However, their effects on hepatic glucose production (HGP) in obesity are not clear. This study was designed to test the hypothesis that gluconeogenesis and HGP can be modulated by DPP-4 inhibitors in obesity.

Methods  Sprague Dawley male rats were divided into four groups, each on a different diet: general rat chow, n=10 (G); G+sitagliptin, n=10; high fat chow (obesity), n=10 (55% fat calories, HFO); HFO+sitagliptin, n=10. After 10 weeks, the rats were fasted overnight and glucose metabolism was determined using 3-³H-glucose and ¹⁴C-glycerol as tracers.

Results  Glycerol rate of appearance (P <0.00001), plasma glycerol (P <0.05) and free fatty acid (FFA) (P <0.05) concentrations, and HGP (P <0.05) were decreased in HFO+sitagliptin group compared with HFO group, but there was no significant difference between G and G+sitagliptin groups (P >0.05). Gluconeogenesis in HFO group was five times of that in G rats (P <0.01), but was significantly declined in HFO+sitagliptin group (P <0.0001).

Conclusions  Gluconeogenesis and HGP were inhibited by sitagliptin in high fat-induced obese rats due to decreased glycerol availability, which was a result of reduced glycerol release from adipose tissues. The finding suggests that sitagliptin is potentially useful for controlling fasting glucose in obesity, thereby delaying or preventing the development of diabetes.

     

Anti-catabolic effect of caffeic acid phenethyl ester, an active component of honeybee propolis on bone loss in ovariectomized mice: a micro-computed tomography study and histological analysis

Background Osteoporosis （OP） is a common bone disease,which adversely affects life quality.Effective treatments are necessary to combat both the loss and fracture of bone.Recent studies indicated that caffeic acid phenethyl ester （CAPE） is a natural chemical compound from honeybee propolis which is capable of attenuating osteoclastogenesis and bone resorption.Therefore,this study aimed to investigate the effect of CAPE on bone loss in OP mice using micro-computed tomography （CT） and histology.Methods Eighteen mice were prepared and evenly divided into three groups.The six mice in the sham＋PBS group did not undergo ovariectomy and were intraperitoneally injected with PBS during the curing period.Twelve mice were ovariectomized （OVX） to induce OP.Six of them in the OVX＋CAPE group were intraperitoneally injected with 0.5 mg/kg CAPE twice per week for 4 weeks after ovariectomy.The other six OVX mice in OVX＋PBS group were treated with PBS.All the mice were sacrificed 4 weeks after ovariectomy.The tibias were bilaterally excised for micro-CT scan and histological analysis.The Mann-Whitney U test was used to test the statistical differences among groups.Results Bone loss occurred in OVX mice.Compared with the sham＋PBS group,mice in the OVX＋PBS group exhibited a significant decrease in bone mineral density （BMD,P ＜0.05）,bone volume fraction （BV/TV,P ＜0.01）,trabecular thickness （Tb.Th,P ＜0.05）,and trabecular number （Tb.N,P ＜0.01）,as well as a non-insignificant increase in the number of osteoclasts （N.Oc/B.Pm）.With CAPE treatment,the microarchitecture of the tibial metaphyses was significantly improved with a reduction of osteoclast formation.Compared with the OVX＋PBS group,BV/TV in the OVX＋CAPE group was significantly increased by 33.9％ （P ＜0.05）.Conclusion CAPE therapy results in the protection of bone loss induced by OVX.     

Pioglitazone inhibits the expression of nicotinamide adenine dinucleotide phosphate oxidase and p38 mitogen-activated protein kinase in rat mesangial cells

Background Oxidative Stress and p38 mitogen-activated protein kinase （p38MAPK） play a vital role in renal fibrosis. Pioglitazone can protect kidney but the underlying mechanisms are less clear. The purpose of this study was to investigate the effect of pioglitazone on oxidative stress and whether the severity of oxidative stress was associated with the phosphorylation level of p38MAPK.     

Kyphoplasty versus vertebroplasty for the treatment of malignant vertebral compression fractures caused by metastases: a retrospective study

Background There are few comparative studies regarding kyphoplasty (KP) and vertebroplasty (VP) for the treatment of painful vertebral compression fractures (VCF) in patients with cancer. The purpose of this study is to retrospectively compare KP with VP in pain improvement, cement leakage incidence, and the cost of treatment of malignant VCF.

Methods We performed a retrospective study of clinical data for 80 patients with multiple spinal metastases, treated with KP in 42 cases and VP in 38. Visual analog scale (VAS) scores were collected pre-operatively, post-operatively, at 1 month, 6 months, and 1 year after treatment. Cement leakage was identified using fluoroscopy and CT scan. Total cost per patient was also collected.

Results There was a significant difference between the pre- and post-operative VAS scores (7.4±2.0 to 3.8±1.6, P <0.001 in the KP group; 6.7±2.4 to 3.7±1.4, P <0.001 in the VP group), and was maintained at 1-year follow-up (3.2±1.4 in the KP group, 3.1±1.3 in the VP group). However, the difference in VAS score between these two groups was insignificant at baseline and every follow-up assessment post-operatively (P >0.05). The incidence of cement leakage in the KP group was lower than that of the VP group (16.9% (14/83) vs 30.3% (23/76), P <0.05). However, none of the patients developed any symptoms. The length of postoperative hospital stay in the VP group was shorter than that of the KP group ((2.4±1.3) vs (5.3±1.9) days, P <0.05). Total hospital cost in the KP group was much higher than that of the VP group (RMB Yuan 8 492±3 332 vs RMB Yuan 3 173±1 341, P <0.01).

Conclusions VP and KP are both effective in providing pain relief for patients with cancer-related VCF. KP provides no greater degree of pain improvement. KP is associated with a lower rate of cement leakage compared with VP. VP is associated with lower cost and shorter postoperative hospital stay in China.

     

Tartrate-resistant acid phosphatase 5b is a potential biomarker for rheumatoid arthritis: a pilot study in Han Chinese

Background Bone damage around the joints is one of the major pathophysiological mechanisms that leads to rheumatoid arthritis （RA） chronic disability.Serum tartrate-resistant acid phosphatase 5b （TRACP-5b） is secreted by osteoclasts,its activity can be used as a clinically relevant bone resorption marker.The aim of this study was to test whether the measurement of serum levels of TRACP-5b in patients with RA would correlate with measures of disease activity and with responses to therapy.Methods Fifty-six patients were randomly assigned to receive recombinant human cytotoxic tlymphocyte-associated antigen-4 immunoglobulin （RhCTLA4-lg）,infliximab or methotrexate （MTX）.The clinical and serologic indicators of RA activity were evaluated at baseline and at 24 weeks.Serum TRACP-5b was measured by Enzyme-linked Immunosorbent Assay （ELISA） at 0,12 and 24 weeks.Hand X-rays were obtained at baseline.Results At baseline,the levels of TRACP-5b correlated with the severity of X-ray damage,disease duration （r=0.332,P=0.012）,and tender joint count （r=0.408,P=0.002）.The 24 weeks values of TRACP-5b for RhCTLA4-lg group and infliximab group differed significantly from the baseline values in each group （P 〈0.05; P 〈0.05）,whereas only the value for RhCTLA4-lg group differed significantly from the 24 weeks value for the MTX group （P 〈0.01）.Considering the two biologics-treated groups together,the TRACP-5b levels at 24 weeks differed significantly from the baseline values only in those patients who reached an ACR70 level （P 〈0.05）.Conclusions Measurement of serum TRACP-5b in RA patients reflects clinical and radiological measures of disease activity,treatment with certain biologics,and degree of response to therapy.TRACP-5b should be investigated further as a potential biomarker to predict response to therapy,including slowing of radiographic progression.     

肥胖抑制素及和肽素预警多囊卵巢综合征患者心血管病变的初步研究

目的  研究肥胖抑制素与和肽素在肥胖型与非肥胖型多囊卵巢综合征（PCOS）患者和健康女性体内的表达差异,分析两者与PCOS患者并发心血管疾病危险因素指标的相关性。方法  研究对象分为肥胖组、非肥胖组和对照组,用生化分析仪分析各项生化指标,化学发光法检测C反应蛋白（CRP）含量,空腹胰岛素水平采用激素自动分析仪进行检测,酶联免疫法检测和肽素、肥胖抑制素和睾酮。超声检测研究对象的颈动脉内-中膜厚度（CIMT）。多毛症通过Ferriman-Gallwey评分标准诊断,测量每个研究对象的腰臀比（WHR）和体重指数（BMI）。SPSS 11.5分析和肽素、肥胖抑制素和其他各项指标之间的关系。结果  收缩压、舒张压和CRP在非肥胖组均高于对照组（P <0.05）,肥胖组均高于非肥胖组（P <0.05）。F-G评分分值和总睾酮量在非肥胖组中高于对照组（P <0.05）。而肥胖组显著高于非肥胖组（P <0.05）。肥胖抑制素在非肥胖组明显低于对照组,肥胖组低于非肥胖组（P <0.05）。和肽素在肥胖组显著高于非肥胖组（P =0.002）。通过相关性分析显示肥胖抑制素与心血管危险因素呈负相关。和肽素与心血管危险因素之间呈正相关。结论  肥胖抑制素在PCOS患者中低表达,和肽素在PCOS患者中高表达,在肥胖患者中这种趋势尤为明显。肥胖抑制素与心血管危险因素呈负相关,和肽素与心血管危险因素呈正相关,其均有望成为预测PCOS患者早期心血管病变的标志物。