人硫氧还蛋白基因分子克隆及真核表达载体的构建

目的克隆人硫氧还蛋白（hTRX）cDNA序列并进行真核表达载体的构建。方法应用RT-PCR技术,以胎肝组织细胞总RNA为模板,扩增出hTRX成熟蛋白的cDNA基因,并克隆至pUCm-T载体中;经PCR和测序鉴定正确后,再构建重组真核表达载体pcDNA3.0-hTRX,采用PCR、双酶切和基因测序鉴定。结果将所得序列与GenBank（J04026）提供的序列比较,其酶活性中心（Trp-Cys-Gly-Pro-Cys）和基序与已知序列一致;PCR、酶切及测序鉴定表明真核表达载体构建正确。结论成功克隆编码hTRX成熟蛋白的cDNA基因,并构建其真核表达载体pcDNA3.0-hTRX。     

枳实薤白桂枝汤治疗不稳定型心绞痛30例

目的观察枳实薤白桂枝汤治疗不稳定型心绞痛（UA）的临床疗效及对心电图、基质金属蛋白酶-9（MMP-9）水平的影响。方法将UA患者随机分为两组,对照组给予西医常规治疗,治疗组加用枳实薤白桂枝汤。疗程均为4周。观察两组心绞痛发作情况、心电图ST-T变化、MMP-9水平变化。结果治疗组疗效明显优于对照组,两组心电图NST、MMP-9较治疗前均有明显改善,治疗组优于对照组。结论在西医常规治疗的基础上加用枳实薤白桂枝汤在改善心电图缺血性ST-T改变,减轻心绞痛症状等方面较单用西药效果明显。     

冠心病合并2型糖尿病患者冠状动脉病变特点和随访一年后急性冠脉事件发生率的分析

目的分析和探讨冠心病合并2型糖尿病患者的冠状动脉病变特点和预后。方法选择2008年6月至2010年8月经冠状动脉造影确诊为冠心病的患者398例,其中合并2型糖尿病者137例,非糖尿病患者261例,两组的性别、年龄、高血压、高脂血症和吸烟指数无统计学差异。比较两组患者的临床指标和冠状动脉造影结果。结果 2型糖尿病组冠脉造影积分(2.30±1.00)分,非糖尿病组冠脉造影积分(1.73±0.94)分,(P<0.05);两组多支病变发生率有显著性差异,冠心病合并2型糖尿病组为40.1%,非糖尿病组多支病变为20.0%,(P<0.01);两组弥漫性病变发生率差异亦有显著性,冠心病合并2型糖尿病组为56.9%,非糖尿病组为36.4%,(P<0.05)。随访一年,2型糖尿病组急性冠脉事件的发生率为17.9%,非糖尿病组急性冠脉事件发生率为9.29%,(P<0.05)。结论冠心病合并2型糖尿病患者冠状动脉病变弥漫且更加严重,面临着更高的炎症反应状态,急性冠脉事件的发生率更高。因此积极控制冠心病合并2型糖尿病患者的血糖,强化调脂、降压、抗炎和抗血小板等治疗将具有更重要的临床意义。     

超敏C反应蛋白和冠状动脉造影术确定的冠心病冠脉病变严重程度相关性的直线回归分析

目的探讨血浆超敏C反应蛋白（hSICRP）水平与冠心病发病和通过冠脉造影确定的病变的严重程度的关系。方法选择江苏省人民医院住院行冠状动脉造影术的707例患者,采用Gensini评分计算冠脉造影积分,人院后分别测定患者的血清hs-CRP水平。采用SPSSl5．0统计软件进行直线回归分析。结果直线回归分析结果CRP的回归系数B值为0．104,P〈0．001。结论血浆hs-CRP水平与冠心病冠脉病变的严重程度高度相关。hs-CRP和动脉粥样硬化的严重程度密切相关。     

Effects of Liandou Qingmai Recipe(连豆清脉方) on Endothelin-1,Nitric Oxide,Interleukin-6 and Interleukin-10 Levels in Patients with Coronary Heart Disease

Objective:To observe effects of Liandou Qingmai Recipe(连豆清脉方) on endothelin-1(ET-1),nitric oxide(NO),interleukin-6(IL-6) and IL-10 levels in patients with coronary heart disease.Methods:Total 101 cases with coronary heart disease were randomly divided into a treatment group(n=45) treated by Liandou Qingmai Recipe and a standard treatment group(control group,n=56),with a normal group of 16 health persons set up.Changes of ET-1,NO,IL-6 and IL-10 levels were measured before treatment and after treatment for two weeks.And the data were analyzed by SPSS 16.0 statistic software.Results:Before treatment,the levels of ET-1,IL-6 and IL-10 levels were significantly higher and NO was significantly lower in the patients with coronary heart disease than those in the normal group(90.7±12.7 ng/L vs 41.8±13.5 ng/L,9.17±0.18 ng/L vs 1.10±0.08 ng/L,1.94±0.26 ng/L vs 1.09±0.06 ng/L,and 92.2±17.7 μmol/L vs 124.5±27.2 μmol/L;all P<0.05),with no significant differences in the levels of ET-1,NO,IL-6 and IL-10 between the treatment group and the control group(P>0.05);After treatment,ET-1 and IL-6 significantly decreased in the treatment group and the control group,and NO increased in the treatment group;And IL-6 level was significantly lower and NO level was higher in the treatment group than those in the control group(4.48±1.22 ng/L vs 5.13±1.85 ng/L,117.4±22.3 μmol/L vs 92.4±17.1 μmol/L;both P<0.05);There was a positive correlation between IL-6 and IL-10,and a negative correlation between NO and IL-10(r=0.142,r=-0.152;both P<0.05).Conclusion:Liandou Qingmai Recipe can decline IL-6,IL-10 and ET-1 levels,and raise NO level in patients with coronary heart disease on the basis of standard treatment,so as to inhibit endothelial inflammatory response,improve vascular endothelial function,with stronger anti-AS action;And vascular endothelial lesion is related with inflammatory response.     

吴新欲主任医师治疗慢性心衰学术思想及临床经验初探

吴新欲主任医师为南京中医药大学无锡附属医院心内科主任医师,孟和派第四代传人,"江苏省名中医",全国第3、4批名老中医药专家学术经验继承指导老师,对心血管、消化等多系统的疾病均有丰富的临床经验。笔者有幸随诊学习,获益匪浅,现就其治疗慢性心衰临床经验总结如下,以飨同道。     

心力神对充血性心力衰竭患者血浆BNP、AngⅡ及心功能的影响

目的:观察心力神对充血性心力衰竭患者血浆BNP、AngⅡ水平及心功能的影响.方法:分中药组及对照组均给予抗心衰标准三联疗法,中药组加服心力神(黄芪、党参、麦冬、五味子、补骨脂、茯苓等),治疗3个月后观察疗效.结果:两组患者治疗后左室射血分数、心输出量、心脏指数均较治疗前提高,BNP、AngⅡ水平均较治疗前降低,中药组治疗后左室射血分数、心脏指数高于对照组,BNP、AngⅡ水平低于对照组.结论:心力神能够改善左室收缩功能,抑制神经内分泌激活,减轻心室的容积扩张和压力负荷,与标准治疗结合应用疗效优于对照组.