达格列净在2型糖尿病合并心功能不全患者中应用的临床评价分析

目的:探讨达格列净治疗2型糖尿病合并心功能不全的疗效及对患者心功能、血脂水平的影响.方法:选取我院自2019年1月—2020年1月75例2型糖尿病合并心功能不全患者为观察对象,按照随机数表法分为对照组37例、观察组38例.观察组在对照组基础上给予达格列净5～10mg/d口服治疗.比较两组治疗前、治疗6个月左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左室质量指数(LVMI)、血浆N末端B型利钠肽原(NT-proBNP)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、不良事件.结果:治疗6个月后,两组LVEF升高,其中观察组高于对照组;两组LVEDD、LVMI降低,观察组低于对照组(P<0.05);治疗6个月后两组NT-proBNP、HbA1 c均下降,其中观察组低于对照组(P<0.05);治疗6个月后两组TG、LDL-C下降,其中观察组低于对照组;两组HDL-C水平上升,其中观察组高于对照组(P<0.05);观察组不良事件发生率为21.05％,低于对照组的43.24％(P<0.05).结论:达格列净能够改善2型糖尿病合并心功能不全患者的心功能、糖脂代谢,减少不良事件发生,值得推广.     

催产素的心血管保护作用及其机制研究进展

心血管疾病(CVD)的发病率及病死率仍在全球范围内居高不下,主要诱因包括脂质水平升高、氧化应激、炎症等。催产素是下丘脑合成的神经肽激素,可通过受体发挥作用,其受体是一类G蛋白偶联受体,存在于包括心脏和动脉在内的心血管系统细胞中,可调节与动脉粥样硬化性CVD(ACD)直接相关的因素,如炎症反应、体重增加和胰岛素抵抗,还能降低脂肪和细胞因子含量,提高葡萄糖耐受性,降低血压,缓解焦虑。虽然催产素目前还没有被用于心脏病的治疗中,但已经在动物动脉粥样硬化模型和一些人类研究中显示出积极作用,具有重要的临床应用前景。本文就催产素在人类CVD防治和保护中的作用进行综述。     

基于异方差混合转移分布模型和支持向量机的脑电分类研究

为解决线性分析和单一非线性动力学指标方法无法准确描述脑电信号的问题,本研究提出基于异方差混合转移分布模型脑电特征提取方法。首先对采集到的脑电信号依据条件期望最大化(ECM)算法建立异方差混合转移分布模型,求得模型条件方差序列的均值及方差作为脑电信号的特征,将得到的脑电信号特征采用支持向量机进行分类。通过对6个人的正常脑电信号和带有眼电伪迹脑电信号进行分类仿真实验,其结果表明该方法能很好地拟合出脑电信号,且分类精确度能达到99.166 7%,说明此方法可有效提取脑电特征并准确识别出眼电伪迹。     

羟苯磺酸钙在慢性移植肾肾病中的应用

目的观察应用羟苯磺酸钙治疗慢性移植肾肾病的疗效。方法58例肾移植术后患者出现慢性移植肾肾病后,在调整原有环孢素或他克莫司联合麦考酚酯和肾上腺皮质激素三联免疫抑制治疗方案的基础上加用羟苯磺酸钙（每次0．5g,每日3次,随访12周）。随访观察2组治疗前、后血清肌酐、尿素氮和尿蛋白含量的变化及其不良反应。结果他克莫司组和环孢素组治疗后血清肌酐水平与治疗前比较均有明显下降（均P〈0．01）。他克莫司组和环孢素组24h尿蛋白定量治疗前、后的组内比较有统计学差异（均P〈0．01）。他克莫司组和环孢素组血清尿素氮水平治疗前、后的组内比较有统计学差异（均P〈0．01）。羟苯磺酸钙组治疗期间3例出现恶心、纳差,1例出现头痛,减量后均症状消失。结论加用羟苯磺酸钙可改善慢性移植肾肾病患者的移植肾的肾功能,明显降低尿蛋白。     

正常淋巴液对大鼠急性微循环障碍的干预作用

目的　研究正常淋巴液对高分子右旋糖酐 (Dextran 5 0 0 )所致大鼠急性微循环障碍的干预作用。方法　Wistar大鼠 2 0只 ,均分为两组 ,静注 10 ?xtran 5 0 0 (1g/kg)复制急性微循环障碍模型。造模 6min后 ,颈静脉注射小量肠淋巴液 (模型对照组以等量生理盐水代替 ) ,应用活体显微电视录像技术 ,观察大鼠肠系膜微循环变化 ,同时记录颈总动脉血压及存活时间。结果　①静注 10 ?xtran 5 0 0可引起急性微循环障碍 ,表现为各级微血管口径缩窄、微血流速度变慢、伴有红细胞聚集、积分值显著高于造模前 (P <0 0 5～ 0 0 1) ;②淋巴液可减轻急性微循环障碍 ,其微血管口径缩窄、流态异常、积分值增高、红细胞聚集程度均较对照组为轻 (P <0 0 5～ 0 0 1) ;③模型组血压进行性下降 ,但淋巴液组可维持较高水平 (P <0 0 5 ) ;④淋巴液组的存活时间长于对照组 (P <0 0 5 )。结论　淋巴液能明显改善Dextran 5 0 0所致的急性微循环障碍 ,较好地延缓血压下降并延长存活时间。     

Downregulation of p38 MAPK involved in inhibition of LDL-induced proliferation of mesangial cells and matrix by curcumin

Curcumin, as a main pharmacological component in the traditional Chinese medicine-- tttrmeric, has shown anti-inflammatory, anti-oxidation, anti-tumor and anti-fibrotic effects. This study aimed to investigate the possible underlying signaling pathway which was involved in the inhibition of LDL-induced proliferation of mesangial cells and matrix by curcumin. Rat mesangial cells in vitro were incubated with low-density lipoprotein （LDL） and different concentrations of curcumin （0, 6.25, 12.5, 25.0 9mol/L） or p38 MAPK inhibitor, SB203580 （10 μmol/L）. Under LDL incubation, mesangial cells proliferated, the expression of MMP-2 mRNA and protein was decreased, the expression of COX-2 mRNA and protein was increased, reactive oxygen species （ROS） generation was increased and p38 MAPK was activated significantly （P〈0.05）. When LDL-induced cells were treated with curcumin in the concentration of 12.5 or 25.0 μmol/L, LDL-induced proliferation ofmesangial cells was suppressed, the expression of MMP-2 mRNA and protein increased, the expression of COX-2 mRNA and protein downregulated, the production of ROS inhibited and p38 MAPK inactivated （P〈0.05）. In conclusion, curcumin can inhibit the LDL-induced proliferation of mesangial cells and up-regulate the expression of MMP-2, which may be related with the inhibitory effect of curcumin on COX-2 expression, ROS pro- duction and p38 MAPK.     

Erbin interacts with Sema4C and inhibits Sema4C-induced epithelial-mesenchymal transition in HK2 cells

Erbin, a member of Leucine-rich repeat and PDZ-containing protein family, was found to inhibit TGF-β-induced epithelial-mesenchymal transition （EMT） in our previous study. However, the mechanism of Erbin in regulating EMT is unclear. Semaphorin protein Sema4C, with PDZ binding site at C-terminal has been recognized as a positive regulator of EMT. Here, we aimed to examine the inter- action between Erbin and Sema4C. HK2 cells were treated with TGF-β1, or transfected with Erbin and （or） Sema4C. Interaction of Erbin and Sema4C was identified by immunoprecipitation. RT-PCR was used to detect the expression of Erbin and Sema4C at mRNA level after transfection. The expression levels of Erbin, Sema4C, and markers of EMT were measured by using Western blotting or ELISA. Af- ter HK2 cells were stimulated with 10 ng/mL TGF-β1 for 72 h, the protein expression levels of Erbin and Sema4C were both up-regulated, and immunoprecipitation results showed Erbin interacted with Sema4C in HK2 cells both at endogenous and exogenous levels. Furthermore, overexpression of Sema4C suppressed E-cadherin, induced vimentin and promoted fibronectin secretion, indicating Sema4C promotes the process of EMT. However, HK2 cells overexpressing Erbin were resistant to Sema4C-induced EMT. In contrast, Erbin specific siRNA promoted EMT induced by Sema4C. Taken together, these results suggest that Erbin can interact with Sema4C, and co-expression of Erbin blocks the process of Sema4C-induced EMT.     

尿蛋白阴性及尿微量白蛋白阳性糖尿病患者血β_2-微球蛋白水平的研究

目的观察血清β2微球蛋白(β2-MG)在尿白蛋白阴性及尿微量白蛋白阳性糖尿病患者的水平。方法收集住院、门诊及查体经确诊的糖尿病患者的血液和随意尿液标本,分别检测血β2-MG、空腹血糖和尿糖、尿微量白蛋白、尿蛋白,按尿白蛋白排泄率分成3个亚组,将每亚组间的β2--MG的值分别进行比较分析。结果尿微量白蛋白阴性、阳性组和尿白蛋白定性阳性组与对照组比较,进行统计学分析。糖尿病患者3亚组与对照组比较有统计学意义,尿蛋白定性阳性组与尿微量白蛋白阳性组与阴性组β2-MG有统计学意义(P<0.01)。结论血清β2-MG在尿微量白蛋白定量阴性、及阳性的糖尿病患者中,具有重要的诊断价值,可作为糖尿病肾病的早期敏感试验。联检尿微量白蛋白可提高诊断的阳性率和准确率。     

奥利司他胶囊溶出度检测

目的 建立奥利司他胶囊的溶出度检测方法.方法 采用桨法,加沉降篮,溶出介质3.5％十二烷基硫酸钠水溶液900mL,75r/min,采用高效液相色谱法测定溶出液含量,Agilent SB-C18色谱柱(4.6mm× 100mm,2.7μm),流速1.5mL/min,流动相为乙腈-水(84∶16,V/V),检测波长205nm,柱温35℃,进样量20μL.结果 主成分奥利司他在0.026～0.180mg/mL浓度范围内线性关系良好,相关系数r=0.9999,平均回收率为96.9％,分析时间较短.结论 该方法专属性强,准确度好,检测效率高可作为奥利司他胶囊溶出度检查的质量控制方法.