散射免疫比浊法检测类风湿性关节炎患者血清CRP和免疫球蛋白研究

目的探讨散射免疫比浊法检测类风湿性关节炎患者血清CRP和免疫球蛋白的意义。方法采用散射免疫比浊法对63例类风湿性关节炎患者血清CRP和血清免疫球蛋白(IgG、IgA、IgM)进行检测,同时35例健康体检者作为对照,分析其结果。结果类风湿性关节炎患者与正常人比较血清CRP、IgG、IgA、IgM水平升高,活动期患者与正常组相比差异有统计学意义(P<0.01);非活动期患者与正常组相比差异也存在统计学意义(P<0.05)。经治疗后,患者治疗后血清CRP显著低于治疗前(P<0.01),而血清免疫球蛋白(IgG、IgA和IgM)无显著变化(P>0.05)。结论检测类风湿性关节炎患者血清CRP和免疫球蛋白(IgG、IgA、IgM)水平的变化规律,对临床诊断、评价疗效和预后提供一定的参考依据。     

氧化型低密度脂蛋白的内皮损伤作用及其对人脐静脉内皮细胞中OX40L表达的影响

目的观察氧化型低密度脂蛋白(Oxidized low-density lipoprotein,ox-LDL)的内皮损伤作用及其对人脐静脉内皮细胞(Human umbilical vein endothelial cell,HUVEC)中OX40L表达的影响。方法采用CCK-8法检测不同浓度ox-LDL(50、100和150 mg/L)对HUVEC增殖活力的影响;流式细胞术检测100 mg/L ox-LDL处理的HUVEC细胞周期及凋亡率的变化;Western blot法检测不同浓度ox-LDL(50、100和150 mg/L)处理的HUVEC中OX40L蛋白的表达水平;免疫荧光及激光共聚焦检测100 mg/L ox-LDL处理的HUVEC中OX40L蛋白的定位,均设加入等量培养基的HUVEC作为对照组。结果与对照组相比,随着ox-LDL浓度的升高,HUVEC的增殖活力明显降低,差异均有统计学意义(P<0.01);ox-LDL 100 mg/L组细胞被阻滞在S期,凋亡率明显增加,差异均有统计学意义(P<0.05);与对照组相比,随着ox-LDL浓度的升高,HUVEC中OX40L的表达量逐渐升高,差异均有统计学意义(P<0.05);ox-LDL100 mg/L组HUVEC表达OX40L的荧光明显增强,差异有统计学意义(P<0.01),且OX40L蛋白定位于细胞膜及细胞质上。结论 ox-LDL对HUVEC具有明显的损伤作用,可促进HUVEC中OX40L的表达,影响OX40/OX40L炎症信号通路。     

充血性心力衰竭患者血清CRP水平的变化及与心功能的关系

采用免疫比浊法测定充血性心力衰竭(CHF)患者血清CRP水平,超声心动图检查LVEF、LVEDd。得到的结果是:CHF患者血清CRP水平显著高于对照组(P<0.01),随心衰加重,血清CRP水平明显升高。     

C反应蛋白在急性冠脉综合征中的临床意义

目的探讨C反应蛋白(CRP)与急性冠脉综合征(Acute coronary syndromesACS的)关系。方法测定经冠脉造影确诊的冠心病患者60例(其中急性冠脉综合征患者30例,非急性冠脉综合征的冠心病患者30例)和冠脉造影排除冠心病患者30例的血CRP浓度。结果ACS患者组(A组)血CRP浓度为(14.53±16.87)mg/dL;非ACS患者组(B组)血CRP浓度为(4.07±4.56)mg/dL;对照组(C组)血CRP浓度为(3.67±4.43)mg/dL,A组与B组之间CRP浓度有显著性差异(P<0.001);B组与C组之间CRP浓度无显著性差异。结论急性冠脉综合征患者血CRP浓度明显升高,提示炎症反应与急性冠脉综合征密切相关,CRP浓度测定可作为急性冠脉综合征的监测指标。     

血清C反应蛋白水平与脑梗死的相关分析

目的探讨C反应蛋白水平在不同类型急性脑梗死(ACL)患者血清中的变化规律及其临床意义。方法采用酶联免疫吸附法(ELISA法)对100例本院住院的脑梗死(发病1周内)进行CRP水平测定,其中大动脉粥样硬化梗死24例,小动脉闭塞性脑梗死27例,心源性栓塞性脑梗死2例,其他病因明确性脑梗死34例,不明病因性脑梗死13例,并进行对照分析。结果以CO中毒为主要危险因素组,其次冠心病组;高血压组与糖尿病组组间对比无明显差异。结论血清CRP可能在ACI患者的发生、发展中起一定作用,且水平随卒中类型的不同而变化。     

冠心病患者血清尿酸水平的相关性观察

目的 分析冠心病患者血清尿酸(LA)水平与冠心病的相关性.方法 97例行冠状动脉造影(CAG)诊断为冠心病患者分别于29倒CAG检查未见异常者对照,全部研究对象用尿酸酶比色法检测UA及冠心病易患因素,并统计其相关性.结果 冠心病组患者血清UA水平明显高于非冠心病对照组,多元回归分析结果显示血清UA水平并非冠心病独立危险因素.结论 高uA血症可能与冠心病发病相关.     

急性冠脉综合征患者血浆PAPP-A与sCD40L的临床意义

大量的临床资料证实炎症反应是冠心病发生、发展的病理基础,导致冠状动脉粥样斑块的纤维帽变薄、破裂、出血及血栓形成,说明炎症因子在冠心病的过程中也同样发挥着重要作用,本实验通过测定ACS患者来探讨炎症因子在急性心肌梗死患者中临床意义。     

呈递预测的小鼠OX40胞外域抗原表位重组病毒样颗粒的制备

目的 制备呈递预测的小鼠OX40胞外域抗原表位重组病毒样颗粒(virus-like particles,VLPs),为进一步以主动免疫方式靶向OX40调控T细胞免疫功能奠定基础.方法 通过抗原数据库中氨基酸的出现频率,对肽段氨基酸组成进行分析,获得其作为抗原表位的潜能,从而预测潜在的OX40线性B细胞表位;经基因重组技...     

钯催化的Heck和Suzuki偶联反应中催化配体发展进程

文按照不同类别的催化配体的进展及特点进行了综述。     

缺血性脑卒中患者急性期C反应蛋白水平与病情及预后的相关性分析

目的探讨缺血性脑卒中患者急性期C反应蛋白(CRP)水平与病情严重程度、预后的相关性。方法对符合入选标准的75例缺血性脑卒中患者,在发病后24h内抽取血清测定CRP水平,按脑卒中患者临床神经功能缺损程度评分标准(CNFDS)进行评分,所有患者行CT或MRI检查,在出院时对预后进行评定。结果CRP异常组脑梗死28例,明显高于腔隙性梗死13例;CRP异常组患者CNFDS评分较高,中位数为17(5~34),且预后不良。结论缺血性脑卒中患者急性期C反应蛋白水平可作为反映脑卒中病情严重程度及预后的一个重要指标。     

平板运动试验与冠状动脉造影诊断冠心病的对照分析

目的探讨活动平板运动试验(TET)对冠心病(CHD)的诊断价值。方法对200例拟诊为冠心病患者先后行平板运动试验和冠状动脉造影检查(CAG)。根据冠状动脉造影结果将患者分成冠心病组和非冠心病组,并对运动试验结果进行对比分析。结果200例患者中确诊为冠心病者149例,其中平板运动试验阳性127例(85.23%),阴性22例(14.77%);非冠心病者51例,平板运动试验阳性14例(27.45%),阴性37例(72.55%)。运动试验诊断冠心病的敏感性为85.23%,特异性为72.55%,阳性预测值为90.08%,阴性预测值为62.71%。平板运动试验对冠心病患者多支血管病变及左主干病变检出率明显高于单支血管病变(P<0.01)。结论平板运动试验诊断冠心病敏感度和特异度较高,尤其对多支血管和左主干病变患者,是一种较理想的无创性的检查方法。     

丹芎通脉颗粒治疗冠心病心绞痛的临床研究

目的对丹芎通脉颗粒治疗冠心病心绞痛的疗效及安全性作出评价。方法采用随机对照,治疗组(A组)171例口服丹芎通脉颗粒(每次2袋,2次/d),对照组(B组)75例给予参芍胶囊口服(每次4袋,2次/d)。4周后进行心绞痛、主要症状、心电图、总有效率及毒副作用评估。结果治疗组心绞痛总有效率96.49%,明显优于对照组77.34%(P<0.01);治疗组心电图总有效率73.10%,明显优于对照组48.00%(P<0.01);治疗组对轻、中、较重度患者均有很好疗效。结论丹芎通脉颗粒治疗冠心病心绞痛疗效确切,无毒副作用。     

Roles of OX40 and OX40 Ligand in Mycosis Fungoides and Sézary Syndrome

Mycosis fungoides (MF) and Sézary syndrome (SS), the most common types of cutaneous T-cell lymphoma (CTCL), are characterized by proliferation of mature CD4+ T-helper cells. Patients with advanced-stage MF and SS have poor prognosis, with 5-year survival rates of 52%. Although a variety of systemic therapies are currently available, there are no curative options for such patients except for stem cell transplantation, and thus the treatment of advanced MF and SS still remains challenging. Therefore, elucidation of the pathophysiology of MF/SS and development of medical treatments are desired. In this study, we focused on a molecule called OX40. We examined OX40 and OX40L expression and function using clinical samples of MF and SS and CTCL cell lines. OX40 and OX40L were co-expressed on tumor cells of MF and SS. OX40 and OX40L expression was increased and correlated with disease severity markers in MF/SS patients. Anti-OX40 antibody and anti-OX40L antibody suppressed the proliferation of CTCL cell lines both in vitro and in vivo. These results suggest that OX40–OX40L interactions could contribute to the proliferation of MF/SS tumor cells and that the disruption of OX40–OX40L interactions could become a new therapeutic strategy for the treatment of MF/SS.     

益赛普治疗类风湿关节炎伴冠心病的临床疗效

目的观察TNFα拮抗剂益赛普治疗类风湿关节炎(Rheumatoid arthritis,RA)伴冠心病的临床疗效。方法选取60例确诊为活动期RA并发冠心病患者,随机分为慢作用药物组(30例,接受慢作用药物治疗,并在整个观察期内保持不变)和益赛普组(30例,在原慢作用药物治疗基础上皮下注射益赛普,每次25 mg,每周2次,持续3个月)。分别于治疗前及治疗12个月后采血,应用全自动荧光偏振免疫分析法测定血清同型半胱氨酸(Homocysteine,HCY)水平;评价临床疗效;经胸超声心动图测定冠状动脉血流储备(Coronary flow reserve,CFR);应用高分辨率B超对所有观察对象的肱动脉进行扫查,测定肱动脉内皮依赖性血管舒张率(Flow-mediated dilation rate,FMD);并记录12个月内发生的心血管疾病、不良反应以及肝肾功能的变化。结果益赛普组治疗后与治疗前比较,患者的血清HCY水平显著下降(P<0.05),CFR和FMD显著升高(P<0.05);慢作用药物组治疗后与治疗前比较,HCY、CFR和FMD均有所下降,但差异无统计学意义(P>0.05);与慢作用药物组比较,经益赛普治疗后,患者血清HCY水平显著下降(P<0.05),CFR和FMD显著升高(P<0.05);益赛普组临床症状缓解有效率明显高于慢作用药物组(P<0.05);12个月内,益赛普组主要心血管疾病发生率与慢作用药物组比较明显降低(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论益赛普可以明显缓解RA患者的临床症状,延缓冠心病的进展,减少心血管危险疾病的发生。     

中西医结合治疗冠心病临床疗效观察

目的观察中西医结合治疗冠心病的临床疗效。方法将80例冠心病患者随机分为对照组与治疗组各40例,2组均予西医常规治疗,治疗组加用自拟益气活血汤治疗,疗程均为4周。结果治疗组心绞痛疗效评定及心电图疗效、血液流变学变化指标均优于对照组。结论中西医结合治疗冠心病疗效可靠。     

Atorvastatin Decreases Triacylglycerol-Associated Risk of Vascular Events in Coronary Heart Disease Patients

High triacylglycerol (TAG) levels may predict vascular risk. The effect of a statin-induced reduction in TAG levels, irrespective of HDL-C increase, on clinical outcome has not yet been addressed by an endpoint study in patients with coronary heart disease (CHD). The GREACE study compared usual with structured care aimed at achieving LDL-C = 100 mg/dL (2.6 mmol/L) by dose titration with atorvastatin. All patients had CHD and were followed for 3 years. This post hoc analysis of GREACE examines the effect of statins on TAG levels and their relation with cardiovascular disease (CVD) events in all patients and in the subgroup of patients with metabolic syndrome (MetS). Baseline TAG levels >150 mg/dL (1.7 mmol/L) were predictive of subsequent CVD events [cardiac mortality, non-fatal myocardial infarction (MI), unstable angina (UA), revascularisation, congestive heart failure (CHF), and stroke] only in statin untreated patients. Stepwise regression analysis showed that with every 20% statin-related TAG reduction there was a decrease in CVD risk by 12% (HR 0.88, 95% CI 0.75–0.95, P = 0.007) in the structured care group vs. the usual care group, by 8% (HR 0.92, 95% CI 0.81–0.97, P = 0.02) in all statin treated patients vs. the untreated ones and by 15% (HR 0.85, 95% CI 0.65–0.94, P = 0.005) in those with MetS treated with a statin vs. those untreated. Using the same analysis but only taking into consideration vascular events (cardiac mortality, non-fatal MI, UA, revascularisation, and stroke) there was a 18% (HR = 0.82, 95% CI 0.57–0.96, P = 0.03) decrease in risk in the MetS (+) patients treated with a statin vs. those not on a statin, and a decrease in risk by 16% (HR = 0.84, 95% CI 0.53–1.07, P = 0.08), when only hard vascular endpoints (cardiac mortality, non-fatal MI, and stroke) were considered. TAG levels are predictive of subsequent CVD events in statin untreated CHD patients. Statin (mainly atorvastatin)-induced decrease in TAG levels was related to a significant reduction in subsequent CVD events. This benefit was more pronounced in CHD MetS (+) patients.     

Higher Lipophilic Index Indicates Higher Risk of Coronary Heart Disease in Postmenopausal Women

Fatty acids (FAs) are essential components of cell membranes and play an integral role in membrane fluidity. The lipophilic index [LI, defined as the sum of the products between FA levels and melting points (°C), divided by the total amount of FA: \({\text{LI}} = \frac{{\mathop \sum \nolimits_{k} [{\text{fatty acid}} \times {\text{melting point}}]}}{{\mathop \sum \nolimits_{k} {\text{fatty acid}} }}\)] is thought to reflect membrane and lipoprotein fluidity and may be associated with the risk of coronary heart disease (CHD). Therefore, we examined the associations of dietary and plasma phospholipid (PL) LI with CHD risk among postmenopausal women. We determined dietary LI for the cohort with completed baseline food frequency questionnaires and free of prevalent cardiovascular diseases in the Women’s Health Initiative (WHI) observational study (N = 85,563). We additionally determined plasma PL LI in a matched case-control study (N = 2428) nested within the WHI observational cohort study. Cox proportional hazard regression and multivariable conditional logistic regression were used to calculate HRs/ORs for CHD risk between quartiles of LI after adjusting for potential sources of confounding and selection bias. Higher dietary LI in the cohort study and plasma PL LI in the case-control study were significantly associated with increased risk of CHD: HR = 1.18 (95% CI 1.07–1.31, P for trend <0.01) and OR = 1.76 (95% CI 1.33–2.33, P for trend <0.01) comparing extreme quartiles and adjusting for potential confounders. These associations still persisted after adjusting for the polyunsaturated to saturated fat ratio. Our study indicated that higher LI based on either dietary or plasma measurements, representing higher FA lipophilicity, was associated with elevated risk of CHD among postmenopausal women.     

The Signaling Role of CD40 Ligand in Platelet Biology and in Platelet Component Transfusion

The CD40 ligand (CD40L) is a transmembrane molecule of crucial interest in cell signaling in innate and adaptive immunity. It is expressed by a variety of cells, but mainly by activated T-lymphocytes and platelets. CD40L may be cleaved into a soluble form (sCD40L) that has a cytokine-like activity. Both forms bind to several receptors, including CD40. This interaction is necessary for the antigen specific immune response. Furthermore, CD40L and sCD40L are involved in inflammation and a panoply of immune related and vascular pathologies. Soluble CD40L is primarily produced by platelets after activation, degranulation and cleavage, which may present a problem for transfusion. Soluble CD40L is involved in adverse transfusion events including transfusion related acute lung injury (TRALI). Although platelet storage designed for transfusion occurs in sterile conditions, platelets are activated and release sCD40L without known agonists. Recently, proteomic studies identified signaling pathways activated in platelet concentrates. Soluble CD40L is a good candidate for platelet activation in an auto-amplification loop. In this review, we describe the immunomodulatory role of CD40L in physiological and pathological conditions. We will focus on the main signaling pathways activated by CD40L after binding to its different receptors.     

Statin Treatment Improves Plasma Lipid Levels but not HDL Subclass Distribution in Patients Undergoing Percutaneous Coronary Intervention

Despite the established efficacy of statin therapy, the risk of cardiovascular events remains high in many patients. We examined high-density lipoprotein (HDL) subclass distribution profiles among statin-treated coronary heart disease (CHD) patients undergoing percutaneous coronary intervention (PCI). Plasma HDL subclasses were measured in 85 patients with established CHD and quantified by two-dimensional gel electrophoresis and immunoblotting. In CHD patients with statin treatment, the mean value of total cholesterol (TC) reached the desirable level and the triacylglycerol level (TAG) was borderline high. Moreover, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoproteinA-I, and apolipoproteinB-100 levels in these patients resembled those in normolipidemic healthy subjects. The HDL subclass did not show a normal distribution and was characterized by the lower large-sized HDL_2b contents and higher contents of small-sized preβ₁-HDL in CHD patients, compared to those in normolipidemic control subjects. Multiple stepwise regression analysis revealed that the severity of coronary stenosis, determined by the Gensini Score, was significantly and independently predicted by HDL_2b and HDL_3b. Statin therapy was effective in modifying plasma lipids levels, but not adequate as a monotherapy to normalize the HDL subclass distribution phenotype of patients with CHD undergoing PCI. The HDL subclass distribution may aid in risk stratification, especially in patients with CHD and therapeutic LDL-C and HDL-C levels.     

强化降脂与介入治疗在冠心病二级预防中的效果比较

目的 探讨比较强化降脂与介入治疗治疗在冠心病二级预防中的效果。方法 选取2009年1月至2010年1月于我院进行治疗的120例冠心病患者为研究对象,将其随机分为A组(强化降脂组)60例和B组(介入治疗组)60例,后将2组患者的心肌梗死发生率、心绞痛发生率、再次住院率及治疗前及治疗后1个月及3个月的血脂、血清hs-CRP、UA水平进行检测及比较。结果 经研究比较发现,A组的心肌梗死发生率、心绞痛发生率、再次住院率均低于B组,A组治疗后1个月及3个月的血清TG、TC及LDL-C、hs-CRP、UA水平均明显低于B组,而血清HDL-C的水平则高于B组,P均<0.05,均有显著性差异。结论 强化降脂治疗在冠心病二级预防中的效果较好,值得临床推广及应用。