阿托伐他汀抑制TRPM2表达和开放对血管内皮氧化应激的影响

为探讨阿托伐他汀对瞬时受体电位通道M2(TRPM2)表达和功能的影响,及其在血管内皮氧化应激损伤中的作用,通过western bloting和细胞钙荧光测定,观察阿托伐他汀预处理对小鼠主动脉内皮细胞TRPM2蛋白表达水平和通道开放的影响,并采用离体主动脉环灌流技术,观察阿托伐他汀对H₂O₂诱导血管内皮功能损伤的改善作用.研究结果表明：经阿托伐他汀预处理7天,可降低小鼠主动脉内皮细胞TRPM2蛋白的表达水平,抑制H₂O₂引起的TRPM2通道开放介导的细胞内钙升高,减轻H₂O₂引起的内皮细胞死亡;经阿托伐他汀急性预处理30 min,可抑制H₂O₂引起的细胞内钙升高;经阿托伐他汀灌胃14天,可减轻H₂O₂引起的小鼠主动脉环内皮依赖性舒张功能损伤;在TRPM2基因敲除小鼠内,阿托伐他汀对血管舒张功能无明显保护作用.由此可见,阿托伐他汀可通过抑制TRPM2通道的表达和开放来减轻血...     

冠心病患者颈动脉粥样硬化与血管内皮舒张功能的临床研究

目的：研究冠心病患者颈动脉粥样硬化与血管内皮舒张功能的临床意义。方法：采用高频超声测量冠心病组和对照组颈动脉斑块积分、斑块数、颈动脉内-中膜厚度（IMT）及血管内皮舒张功能（EDD％），并进行对比分析。结果：1．冠心病组颈动脉IMT、斑块积分及斑块数明显高于对照组，多支冠脉血管病变组明显高于单支病变组；2．冠心病组内皮舒张功能明显低于对照组，单支、双支病变组间无显著性差异。3．冠状动脉造影与颈动脉超声结果比较，以斑块存在为预测冠脉病变的阳性指标，敏感性为83％、特异性75％。结论：冠心病患者多合并血管舒张功能受损及颈动脉粥样硬化，高频超声探查颈动脉可预测冠状动脉病变的存在及严重程度。     

西洛他唑与瑞舒伐他汀治疗2型糖尿病合并冠心病的临床研究

目的 探讨西洛他唑与瑞舒伐他汀对2型糖尿病合并冠心病患者脂代谢的影响。方法 108例2型糖尿病合并冠心病患者,观察患者治疗前后高敏C反应蛋白(hs-CRP)、血清淀粉样蛋白A(SAA)、血浆骨桥蛋白(OPN)、总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等水平变化。结果 患者治疗后TC、TG和LDL-C水平分别为(4.13±1.28)mmol/L、(1.71±0.88)mmol/L和(2.24±0.77)mmol/L均较治疗前有所下降,差异有统计学意义(P<0.05),而治疗后HDL-C水平较治疗前有所提高,差异有统计学意义(P<0.05);患者治疗后SAA、hs-CRP和OPN水平分别为(2.23±0.18)mg/L、(3.11±1.06)mg/L和(68.32±12.05)ng/L显著低于治疗前,差异有统计学意义(P<0.05);未发现有肝肾功能损害等严重不良反应发生。结论 西洛他唑与瑞舒伐他汀治疗2型糖尿病合并冠心病,能有效改善患者血脂情况,降低SAA、hs-CRP和OPN水平。     

格列喹酮联用瑞舒伐他汀钙对2型糖尿病大鼠血糖、血脂的影响

目的：考察格列喹酮（15 mg/kg）联用瑞舒伐他汀钙（10 mg/kg）对血脂异常的2型糖尿病（T2DM）大鼠的影响.方法：将雄性SD大鼠分为正常（NG）组、模型（MG）组、格列喹酮（G）组、瑞舒伐他汀钙（R）组和格列喹酮联用瑞舒伐他汀钙（R-G）组,每组6只.除NG组大鼠外,其余大鼠均给予高糖高脂饲料,持续喂养4周,并对高脂饲料喂养的大鼠腹腔注射STZ(40 mg/kg)诱发T2DM进行实验.给药7 d后,测定各组大鼠的糖脂代谢功能指标（FBG、GHb、TG、TC、LDL-C、HDL-C）、胰岛素功能指标（FINS、Homa-IR）和体重变化.结果：与瑞舒伐他汀钙单用相比,联用药组FBG、GHb、FINS、Homa-IR、TG、LDL-C水平明显下降（P<0.05或P<0.01）,HDL-C水平明显上升（P<0.01）.与格列喹酮单用相比,联用药组FINS、Homa-IR、TG、LDL-C水平明显下降（P<0.05或P<0.01）,HDL-C水平明显上升（P<0.05）.结论：格列喹酮联用瑞舒伐他汀钙对糖尿病大鼠血脂异常的改善作用较格列喹酮或瑞舒...     

颈动脉内膜中层厚度与心血管危险因素聚集性的关系

目的:通过对颈动脉IMT(颈动脉内中膜厚度intima-media thickness)和粥样斑块进行超声检测,分析心血管危险因素聚集性与颈动脉粥样硬化的关系.方法:227例受检者,男139例,女88例,年龄45～57岁(平均53.25±3.01岁).大部分受检者有多重危险因素但临床上无严重动脉粥样硬化疾病并以药物治疗为主.1.记录身高、体重、腰围及血压、空腹血糖、血脂,吸烟史及家族史.2.颈动脉彩色多普勒超声检查:分别测量颈总动脉、颈动脉膨大处,颈内动脉取平均IMT.3.根据颈动脉超声结果分组,正常对照组,IMT增厚组,斑块形成组.4.冠心病危险因素按国际标准确定:危险因素评分范围为0～5,以危险因素评分≥2定义为危险因素聚集.结果:1.各组间心血管危险因素水平的比较 :三组有统计学意义(P＜0.05).并且随血压、血糖、胆固醇、腰围水平升高,随LDL-L下降,颈动脉(IMT)加重.2.各组间心血管危险因素异常检出率比较:高血压、高血糖、高胆固醇血症、高LDL-C血症组间比较有统计学意义(P＜0.05),随颈动脉IMT加重,高血压、高血糖、高胆固醇血症、高LDL-C血症异常检出率明显升高.3.各组心血管危险因素积分比较:根据心血管危险因素积分按等级检验进行秩和检验(H=20.16,P＜0.05),并且随IMT增厚,危险因素积分逐渐升高.4.颈动脉IMT与心血管危险因素的相关分析:在双变量Spearsman相关分析中,颈动脉内中膜厚度与各危险因素及危险因素评分呈显著相关(P＜0.05),在调整性别、年龄进行偏相关分析中,IMT与舒张压、HDL-C的相关性无统计学意义(P＞0.05),与FBG、SBP、TC、TG、LDL-C、RFS存在显著相关性(P＜0.01).IMT与危险因素评分的相关系数分别为0.407与0.219.结论:心血管危险因素的聚集,提示颈动脉粥样硬化程度严重,预示颈动脉粥样硬化病变与多种心血管危险因素的聚集有显著相关性.     

同型半胱氨酸水平与高血压病患者颈动脉斑块的相关性

[目的]探讨同型半胱氨酸(Hcy)与高血压患者颈动脉粥样硬化的关系。[方法]采用高效液相色谱分析法检测血清同型半胱氨酸(Hcy)水平,以高频超声检测患者颈动脉斑块。依斑块的有无进行分组,72例颈动脉斑块患者为斑块组,54例无颈动脉斑块患者对照组。[结果]68.9%斑块组患者(51例)伴Hcy升高,平均血浆Hcy水平19.65±13.43,明显高于对照组(P<0.01)。[结论]高同型半胱氨酸血症与颈动脉斑块发生密切相关,可能是高血压患者的颈动脉粥样硬化的独立危险因素之一。     

2003年理科综合能力测试试题(一)

第1卷(选择题共20题,每题6分共120分)在下列各题的四个选项中,只有一个选项是符合题意. 1.硒缺乏会导致血液胆固醇浓度升高.他汀能改善内皮细胞功能,增加一氧化氮的生成,扩张血管,保持血管内皮的光滑性.他汀药物的药理效用是     

阿托伐他汀治疗非缺血性心脏病慢性心衰患者的疗效观察

目的:本文评价阿托伐他汀对非缺血性心脏病患者心力衰竭的疗效.方法:将86例非缺血性心脏病合并慢性心衰患者随机分为2组,对照组(常规治疗组n=43)服用β受体阻滞荆 ACEI 利尿剂,治疗组(n=43)在对照组治疗的基础上加服阿托伐他汀(10mg/d),随访1年.结果:合用阿托伐他汀能明显改善心功能.提高EF,缩小左室舒张末内径.结论:阿托伐他汀联合神经内分泌拮抗荆能提高非缺血性心脏病合并慢性心衰的治疗效果.     

桂枝汤对动脉粥样硬化大鼠血管活性物质的影响

目的:研究桂枝汤对长期高脂饲料喂养引起的大鼠动脉粥样硬化模型血脂和血管内皮活性因子的作用.方法:48只大鼠随机分为5组:正常组(普通饲料),n=8;模型组(高脂饲料喂养复制大鼠动脉粥样硬化模型),n=10;阳性对照组(模型组加辛伐他汀灌胃),n=10;桂枝汤低浓度组(模型组加桂枝汤10g/(kg·d)灌胃),n=10;桂枝汤高浓度组(模型组加桂枝汤20g/(kg·d)灌胃),n=10.喂养14周用光镜观察动脉斑块形成后检测各组血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),放免法测定血浆内皮素(ET)和血管紧张素Ⅱ(AngⅡ)含量.结果:桂枝汤持续治疗6周后,相对于模型组,血清TG、TC、LDL-C浓度降低(P<0.01),HDL-C浓度升高(P<0.01),ET和AngⅡ含量降低(P<0.01).结论:桂枝汤可降低血脂和血管内皮活性因子,保护血管内皮,改善血管内皮功能.     

不同剂量烟酸治疗高脂血症的疗效及安全性探讨

烟酸有降低胆固醇的作用,有文献报导口服每天可服用1～3g。但在1～3g之间多少剂量最有效,不良反应如何,文献报道较少,我们就这一问题给予观察。 1 临床资料 1.1 一般资料 以门诊病人为主,胆固醇≥190mg/ml为入选标准,继发高脂血症、糖尿病、转氨酶升高、痛风、高尿酸血症等排除在外。入选27人,男23例,女4例,年龄区间32～66岁,平均年龄为49岁。 1.2 服药方法 入睡前一次性服药。第一周服     

Effects of light curing modes and ethanol-wet bonding on dentin bonding properties

Objective

This study explored the effects of different light curing modes and ethanol-wet bonding on dentin bonding strength and durability.

Methods

A total of 54 molars were randomly divided into three groups: Single Bond 2, Gluma Comfort Bond, and N-Bond. Based on the three light-curing modes and presence or absence of ethanol pretreatment, the samples were assigned to six subgroups: high-light mode, ethanol pretreatment+high-light mode, soft-start mode, ethanol pretreatment+soft-start mode, standard mode, and ethanol pretreatment+standard mode. All samples were bonded with resin based on the experimental groups. After 24 h and 6 months of water storage, a universal testing machine was used to measure microtensile bond strength. Scanning electron microscopy (SEM) was applied to observe mixed layer morphology.

Results

The 24-h and 6-month microtensile bond strengths of the ethanol pretreatment groups were significantly higher than those of the non-ethanol pretreatment groups at the same light modes (P<0.05). With or without ethanol pretreatment, the microtensile bond strengths of the high-light modes were significantly lower than those of the soft-start modes and standard modes (P<0.05). The microtensile bond strengths of samples from the 6-month water storage group significantly decreased compared with those of samples from the 24-h water storage group (P<0.05). The soft-start groups and standard groups formed better mixed layers than the high-light mode groups, whereas the ethanol pretreatment groups formed more uniform mixed layers than those without ethanol pretreatment.

Conclusions

Ethanol-wet bonding technique, soft-start, and standard modes could improve dentin bonding properties.

     

Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience

Objective

The aim of this study was to compare complications and oncologic outcomes of patients undergoing laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (LDP) at a single center.

Methods

Distal pancreatectomies performed for pancreatic ductal adenocarcinoma during a 4-year period were included in this study. A retrospective analysis of a database of this cohort was conducted.

Results

Twenty-two patients underwent LDP for pancreatic ductal adenocarcinoma, in comparison to seventy-six patients with comparable tumor characteristics treated by LDP. No patients with locally advanced lesions were included in this study. Comparing LDP group to LDP group, there were no significant differences in operation time (P=0.06) or blood loss (P=0.24). Complications (pancreatic fistula, P=0.62; intra-abdominal abscess, P=0.44; postpancreatectomy hemorrhage, P=0.34) were similar. There were no significant differences in the number of lymph nodes harvested (11.2±4.6 in LDP group vs. 14.4±5.5 in LDP group, P=0.44) nor the rate of patients with positive lymph nodes (36% in LDP group vs. 41% in LDP group, P=0.71). Incidence of positive margins was similar (9% in LDP group vs. 13% in LDP group, P=0.61). The mean overall survival time was (29.6±3.7) months for the LDP group and (27.6±2.1) months for LDP group. There was no difference in overall survival between the two groups (P=0.34).

Conclusions

LDP is a safe and effective treatment for selected patients with pancreatic ductal adenocarcinoma. A slow-compression of pancreas tissue with the GIA stapler is effective in preventing postoperative pancreatic fistula. The oncologic outcome is comparable with the conventional open approach. Laparoscopic radical antegrade modular pancreatosplenectomy contributed to oncological clearance.

     

Dopamine receptor D2 polymorphism is associated with alleviation of obesity after 8-year follow-up: a retrospective cohort study in obese Chinese children and adolescents

Objective

The aim of this study was to explore the association of dopamine receptor D2 (DRD2) polymorphism and alleviation of obesity in children and adolescents after 8-year follow-up.

Methods

This retrospective cohort study included obese children and adolescents with a follow-up period of 8 years. Baseline clinical characteristics and DRD2 polymorphisms (including rs1076562, rs2075654, and rs4586205) were extracted from medical records. A follow-up visit was performed in May 2017 to collect related data including height, weight, diet compliance, and exercise compliance.

Results

One hundred and nine obese children and adolescents were included in the current study. Among three DRD2 single nucleotide polymorphisms, only rs2075654 had a statistically significant association with alleviation of obesity, as the alleviation rate for minor allele carriers (68.6% for TC+TT) was higher compared to the major allele homozygote (43.3% for CC). After adjusting for all related factors, the hazard ratio of rs2075654 minor allele carriers for the alleviation of obesity was 3.34 (95% confidence interval (CI): 1.30?8.58).

Conclusions

The rs2075654 polymorphism of DRD2 is related to long-term obesity alleviation in obese Chinese children and adolescents.

     

Effect of corticosteroids on atrial fibrillation after catheter ablation: a meta-analysis

Objective

The purpose of this meta-analysis was to explore the effect of corticosteroids on atrial fibrillation (AF) following catheter ablation.

Methods

We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for published articles describing the effect of corticosteroids in preventing AF recurrence after catheter ablation. Data on study and patient were extracted. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated by use of a random-effect model, and P values of <0.05 were considered significant.

Results

Two randomized controlled trials (RCTs) and three cohort studies involving 846 patients were included in this meta-analysis. Within one month of catheter ablation, corticosteroid use was associated with a declined risk of recurrence of AF in RCT (RR 0.57, 95% CI 0.39 to 0.85, P=0.005), but without significant effect in cohort studies (RR 1.01, 95% CI 0.79 to 1.30, P=0.94). After three months of catheter ablation, corticosteroids did not have a significant effect in the prevention of late recurrence of AF in either RCT (RR 0.78, 95% CI 0.38 to 1.59, P=0.49) or cohort studies (RR 0.96, 95% CI 0.70 to 1.31, P=0.78).

Conclusions

Our meta-analysis suggested that periprocedural administration of corticosteroids of catheter ablation was associated with reduction of early but not late recurrence of AF.

     

<Emphasis Type="Italic">Ureaplasma urealyticum</Emphasis>-derived lipid-associated membrane proteins introduce IL-6, IL-8, and TNF-α cytokines into human amniotic epithelial cells via Toll-like receptor 2

Objective

The purpose of this study was to determine the role of Ureaplasma urealyticum-derived lipidassociated membrane proteins (LAMPs) in the host innate immune system, specifically their effect on Toll-like receptors (TLRs).

Methods

LAMPs were derived from U. urealyticum strains, and human amniotic epithelial cells (HAECs) were isolated from healthy full-term placentas. Cytokine concentrations were determined by enzyme-linked immunosorbent assay (ELISA) and TLR2 mRNA by real-time PCR. Expression of TLR2 was confirmed by Western blotting and immunohistochemistry.

Results

LAMPs induced HAECs to produce inflammatory cytokines interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α. Cytokine production was reduced after blocking TLR2 using TLR2 inhibitor (anti-hTLR2-IgA).

Conclusions

LAMPs isolated from U. urealyticum induced TLR2-dependent up-regulation of inflammatory genes and cytokines in HAECs.

     

Efficacy of amiodarone and lidocaine for preventing ventricular fibrillation after aortic cross-clamp release in open heart surgery: a meta-analysis of randomized controlled trials

Objective

The relative preventative efficacy of amiodarone and lidocaine for ventricular fibrillation (VF) after release of an aortic cross-clamp (ACC) during open heart surgery has not been determined. This meta-analysis was designed to systematically evaluate the influence of amiodarone, lidocaine, or placebo on the incidence of VF after ACC.

Methods

Prospective randomized controlled trials (RCTs) that compared the VF-preventative effects of amiodarone with lidocaine, or amiodarone or lidocaine with placebo were included. PubMed, EMBASE, and the Cochrane Library were searched for relevant RCTs. Fixed or randomized effect models were applied according to the heterogeneity of the data from the selected studies.

Results

We included eight RCTs in the analysis. Pooled results suggested that the preventative effects of amiodarone and lidocaine were comparable (relative risk (RR)=1.12, 95% confidence interval (CI): 0.70 to 1.80, P=0.63), but both were superior to the placebo (amiodarone, RR=0.71, 95% CI: 0.51 to 1.00, P=0.05; lidocaine, RR=0.63, 95% CI: 0.46 to 0.88, P=0.006). The percentage of patients requiring electric defibrillation counter shocks (DCSs) did not differ significantly among patients administered amiodarone (RR=0.21, 95% CI: 0.04 to 1.19, P=0.08), lidocaine (RR=2.44, 95% CI: 0.13 to 44.02, P=0.55), or the placebo (RR=0.56, 95% CI: 0.25 to 1.25, P=0.16).

Conclusions

Amiodarone and lidocaine are comparably effective in preventing VF after ACC, but the percentage of patients who subsequently require DCSs does not differ among those administered amiodarone, lidocaine, or placebo.

     

Assessments of tear meniscus height,tear film thickness,and corneal epithelial thickness after deep anterior lamellar keratoplasty

Objective

To assess the lower tear meniscus height (LTMH), central tear film thickness (CTFT), and central corneal epithelial thickness (CCET) after deep anterior lamellar keratoplasty (DALK).

Methods

This was a retrospective cross-sectional study of 20 patients who had DALK in one eye over a three-month period. LTMH, CTFT, and CCET of the operated eyes and the unoperated fellow eyes were measured using high-definition optical coherence tomography (HD-OCT). Correlations between three OCT assessments and age, time following surgery, graft size, bed size, and the number of residual sutures were analyzed.

Results

Compared to patients with keratoconus, patients with other corneal conditions had significantly higher CCET in the fellow eye (P=0.024). For all patients, CCET in the operated eye was significantly negatively correlated with the number of residual sutures (R=?0.579, P=0.008), and was significantly positively correlated with time following surgery (R=0.636, P=0.003). In the fellow eye, a significant positive correlation was found between age and CCET (R=0.551, P=0.012), and a significant negative correlation between age and CTFT (R=?0.491, P=0.028). LTMH was found to be significantly correlated between operated and fellow eyes (R=0.554, P=0.011). There was no significant correlation between LTMH and age, bed/graft size, time following surgery, or residual sutures (all possible correlations, P>0.05).

Conclusions

Patients with keratoconus tend to have a thinner central corneal epithelium. Corneal epithelium keeps regenerating over time after DALK. DALK did not induce a significant change in tear volume compared with the fellow eye. Postoperative tear function might depend on an individual’s general condition, rather than on age, gender, bed/graft size, time following surgery, or residual sutures.

     

Radiofrequency ablation versus hepatic resection for breast cancer liver metastasis: a systematic review and meta-analysis

Objective

To evaluate the comparative therapeutic efficacy of radiofrequency ablation (RFA) and hepatic resection (HR) for breast cancer liver metastases (BCLMs).

Methods

Studies that had examined the outcomes for both RFA and HR for BCLM were identified by searching the electronic databases PubMed, EMBASE, and the Cochrane Library. Pooled analyzes of the overall survival (OS), disease-free survival (DFS), and short-term outcomes of BCLM were performed.

Results

Patients with BCLM gained many more survival benefits from HR than from RFA with regard to the 3-year OS rate (combined odds ratio (OR) 0.41, 95% confidence interval (CI) 0.29–0.59, P<0.001), 5-year OS rate (combined OR 0.38, 95% CI 0.32–0.46, P<0.001), 3-year DFS (combined OR 0.36, 95% CI 0.27–0.49, P<0.001), and 5-year DFS (combined OR 0.51, 95% CI 0.40–0.66, P<0.001). RFA had fewer postoperative complications (combined OR 0.30, 95% CI 0.20–0.44, P<0.001) and shorter hospital stays (combined OR -9.01, 95% CI -13.49–4.54, P<0.001) than HR.

Conclusions

HR takes precedence over RFA in the treatment of patients with BCLM, considering the better survival rate. RFA gives rise to fewer complications and can be carried out with a shorter hospital stay, compared to HR. RFA should be reserved for patients who are not optimum candidates for resection.

     

Comparison of laparoscopic hepatectomy,percutaneous radiofrequency ablation and open hepatectomy in the treatment of small hepatocellular carcinoma

Objective

Three mainstream techniques—laparoscopic hepatectomy (LH), percutaneous radiofrequency ablation (pRFA), and open hepatectomy (OH)—were compared in this study, in terms of their efficacies in the treatment of small hepatocellular carcinoma (HCC).

Methods

A comparative study was performed within a total of 94 patients diagnosed with small HCC in our hospital from 2005 to 2010, who underwent LH (28), RFA (33), or OH (33). They had either a single tumor lesion of less than 5 cm or up to three nodules with diameters of less than 3 cm each. Outcomes were carefully evaluated throughout a 3-year follow-up interval and statistically interpreted.

Results

The pRFA group had a significantly lower disease-free survival rate compared with the two surgical groups (P=0.001) and significantly shorter overall survival (P=0.005), while the LH group and the OH group had no difference in survival results. For patients younger than 60 years old, surgical approaches offered a better long-term overall survival prognosis (P=0.008). There were no statistically significant differences among the three groups in overall survival for elderly patients (P=0.104).

Conclusions

Among patients with small HCC, LH may provide better curative effects than pRFA without increasing complication rates. pRFA leads to faster recurrence than surgical resections. LH has similar therapeutic effects to OH and causes less trauma. For patients younger than 60 years old, LH may be the best curative treatment. Elderly patients may choose either surgery or pRFA.