目的 探究Ⅰ型心肾综合征(cardiorenal syndrome,CRS)患者血清脑钠肽(brain natri-uretic peptide,BNP)、胱抑素C(cystatin c,CysC)及肾损伤分子(kidney injury molecule-1,KIM-1)水平,与急性肾损伤(acute kidney injury,AKI)的相关性和预测价值.方法 选取2017年3月～2020年3月南阳市中心医院收治的急性心力衰竭患者211例.其中,合并AKI 89例为观察组,未出现AKI 122例为对照组.根据肾损伤严重程度,将观察组分为轻度组(28例),中度组(46例),重度组(15例)3个亚组.分别检测各组血清BNP、CysC、KIM-1水平.采用Pearson相关分析血清BNP、CysC、KIM-1水平和AKI的相关性.使用受试者工作特征曲线(ROC)评估血清BNP、CysC、KIM-1对Ⅰ型CRS AKI的预测价值.结果 观察组血清 BNP[(1124.36±765.61)ng/L]、CysC[(1.81±0.59)mg/L]及KIM-1[(157.89±16.59)ng/L]水平均高于对照组[(816.56±631.25)ng/L,(0.92±0.08)mg/L,(136.52±13.43)ng/L](t=3.195,16.470,10.328,P=0.001,＜0.001,＜0.001).观察组中,重度组、中度组血清 BNP[(1453.65±668.92)ng/L,(1135.13±459.31)ng/L]、CysC[(2.37±0.63)mg/L,(1.86±0.51)]mg/L 及 KIM-1[(179.86±17.12)ng/L,(158.21±15.56)ng/L]水平与轻度组[(930.26±356.45)ng/L,(1.43±0.46)mg/L,(145.58±14.27)ng/L],3组间存在统计学差异(F＝1.956,12.546,12.165,P=0.034,0.009,0.011).Pearson分析结果显示血清BNP、CysC及KIM-1水平与血清肌酐(Scr)之间均呈正相关(r=0.713,r=0.727,r=0.715,P均＜0.001).ROC曲线分析结果显示血清BNP预测Ⅰ型CRS AKI的AUC为0.716(95％CI:0.603～0.830,P=0.001);血清 CysC 预测 Ⅰ 型 CRS AKI 的 AUC 为0.792(95％CI:0.698～0.897,P＜0.001);血清KIM-1 预测Ⅰ型CRS AK1的AUC为0.749(95％CI:0.641～0.857,P＜0.001);联合指标预测 Ⅰ 型CRS AKI的AUC为0.880(95％CI:0.804～0.955,P＜0.001).结论 Ⅰ 型CRS 患者血清BNP、CysC、KIM-1水平均升高.血清BNP、CysC、KIM-1水平均与病情严重程度密切相关,可以作为反映Ⅰ型CRS病情程度的指标.血清BNP、CysC、KIM-1联合对Ⅰ型CRS AKI的预测具有重要的价值.

Objective:To investigative the molecular mechanism of C-X-C chemokine receptor type 4 (CXCR4) antagonist AMD3100 in epileptic seizure.Methods:(1) Animal experiment: 36 adult male SD rats were randomly divided into control group (Con, n=12), epilepsy group (Epi, n=12), Epi+AMD3100 group ( n=12). Experimental epilepsy rat models in the Epi group were induced by intraperitoneal injection of pentrazole (PTZ, 40 mg/kg); rats in the Epi+AMD3100 group were given intraperitoneal injection of PTZ (40 mg/kg) 20 min after lateral intracerebroventricular injection of 5 μL (5 mg/mL) AMD3100; rats in the Con group were given intraperitoneal injection of normal saline. Racine grading was used to evaluate the levels of epileptic seizure and the latency of epileptic seizure was recorded in rats from each group. EEG was used to record the abnormal discharges of brain neurons in rats from each group. The content of γ -aminobutyric acid (GABA) in the hippocampus was detected by ELISA kit; γ -aminobutyric acid A receptor α1 subunit ( GABAAR α1) mRNA levels of hippocampal neurons in each group were detected by real-time fluorescent quantitative PCR (qRT-PCR). (2) Cell experiment: the hippocampal neurons from 1-d-old SD rats were primarily cultured; 7 d after cultivation, these cells were divided into control group, epilepsy group and AMD3100 group; the cellular epileptic models in the epileptic group were induced by magnesium-free external fluid; neurons in the AMD3100 group were cultured in magnesium-free external solution containing 10 nmol/L AMD3100 for 3 h, and then changed to Neurobasal medium for further culture; cells in the control group were cultured with Neurobasal medium. Whole cell patch clamp technique was used to detect the spontaneous inhibitory postsynaptic currents (sIPSCs) after AMD3100 (10 nmol/L) perfusion. Results:(1) Animal experiment: the seizure latency in Epi+AMD3100 group was significantly shorter than that in Epi group ([663.30±74.84] s vs. [164.40±17.20] s, t=6.490, P<0.001). The frequency of seizures>grading 4 in the Epi+AMD3100 group was significantly decreased as compared with that in the Epi group (3.75±0.39 vs. 9.00±0.73, t=4.680, P<0.001). ELISA results showed that GABA content in the 3 groups was significantly different ( F=17.850, P<0.001): that in the Epi group was significantly lower than that in the Con group, and that in the Epi+AMD3100 group was significantly higher than that in Epi group ( P<0.05). The qRT-PCR results showed that GABAAR α1 mRNA content among the 3 groups was significantly different ( F=14.400, P<0.001): that in the Epi group was significantly lower than that in the Con group, and that in the Epi+AMD3100 group was significantly higher than that in the Epi group ( P<0.05). EEG results showed that the discharge frequency of rats in the Epi+AMD3100 group was lower than that in Epi group; there was no significant difference in EEG power among the 3 groups ( F=3.220, P<0.001), but the EEG power in the Epi+AMD3100 group was lower than that in Epi group and control group. (2) Cell experiment: patch clamp technique showed that the average frequency and amplitude of sIPSCs in the 3 groups were statistically significant ( F=13.670, P<0.001; F=10.920, P<0.001). As compared with those in the control group and epilepsy group, the average frequency and amplitude of sIPSCs in AMD3100 group were significantly increased ( P<0.05). Conclusion:CXCR4 antagonist AMD3100 can reduce seizure frequency by enhancing inhibitory neurotransmission.

目的 探讨果蝇zeste基因增强子的人类同源物2(EZH2)在胶质瘤大鼠胶质瘤组织中的表达及意义.方法 将48只雄性Sprague Dawley大鼠随机分为对照组(n=24)和模型组(n=24).模型组大鼠颅内注射10μL C6胶质瘤细胞悬液(1×109 L-1)制备胶质瘤模型,对照组大鼠注射等量的磷酸盐缓冲液.造模后2周通过测量肿瘤体积、观察肿瘤细胞形态来判断造模是否成功.应用蛋白质印迹和免疫组织化学法检测对照组大鼠脑组织和模型组大鼠肿瘤组织中EZH2蛋白表达,实时荧光定量聚合酶链反应技术检测对照组大鼠脑组织和模型组大鼠肿瘤组织中EZH2 mRNA表达.结果 模型组22只大鼠造模成功.模型组大鼠肿瘤组织中EZH2 mRNA和蛋白表达量均显著高于对照组(P<0.05).结论 胶质瘤大鼠肿瘤组织中EZH2的表达增加,EZH2可能参与胶质瘤的发生、发展过程.

目的:研究非小细胞肺癌(non-small cell lung cancer,NSCLC)患者表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变与中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、系统性炎症反应指数(SIRI)三种炎性指标及患者临床病理学特征的相关性.方法:通过回顾性分析的方法比较136例非小细胞肺癌患者EGFR突变型与野生型在各项临床指标、外周血三种免疫细胞及炎症指标上的差异.结果:EGFR野生型患者与突变型患者在性别、吸烟史、病理类型上比较,差异有统计学意义(P<0.05).EGFR突变型相较于野生型以未吸烟、女性患者、腺癌患者居多.EGFR野生型与突变型在NLR、LMR、SIRI上差异有统计学意义(P<0.05).EGFR突变型患者治疗前LMR高于野生型患者,EGFR突变型患者治疗前NLR和SIRI低于野生型患者.结论:炎症指标LMR、NLR、SIRI与NSCLC患者EGFR突变具有相关性.LMR对EGFR突变有一定的预测价值,且优于SIRI与NLR.

目的 研究神经胶质瘤患者血清中CD26水平的表达,并探讨其临床意义.方法 根据2016版WHO中枢神经系统肿瘤分类收集郑州大学附属肿瘤医院住院的70例不同病理级别的胶质瘤患者血液样本,应用酶联免疫吸附试验(ELISA)测定70例患者手术前和20例健康对照组血清CD26蛋白水平变化,并分析与WHO病理分级及患者临床病理特征的相关性.应用实时荧光定量PCR(qRT-PCR)技术检测不同病理级别胶质瘤组患者和对照组CD26 mRNA水平变化.应用在线String数据库、GO功能注释和京都基因与基因组百科全书KEGG数据库分析CD26相互作用的可能相关蛋白PPI网络及参与的信号通路.结果 胶质瘤患者手术前血液中CD26蛋白水平和mRNA水平显著高于健康对照组(P=0.000,P<0.01),并且随着WHO病理分级的增高而增加(P=0.000).进一步研究发现胶质瘤患者血清CD26水平与IDH1/2的状态密切相关(P<0.05),与年龄、性别、原发肿瘤直径、部位、远处转移、ATRX状态、放化疗以及癫痫发生病史无关(P>0.05).PPI网络结果发现与CD26蛋白相互作用的10个蛋白分子网络.GO功能注释和KEGG通路富集分析显示CD26参与遗传发育、信号通路过程.结论 CD26水平在胶质瘤中显著增加并与胶质瘤的病理级别密切相关,可作为胶质瘤的新型分子标志物,有助于评估病情和评价疗效.

目的 探索尿激酶原联合瑞舒伐他汀(RSV)对急性心肌梗死大鼠的影响.方法 运用结扎左冠动脉前降支制备急性心肌梗死大鼠模式,将60只SPF级SD大鼠按体重随机均分为假手术组、模型组、RSV组、RSV+尿激酶原组,连续干预4周,比较各组大鼠血流动力学、心肌梗死面积、心肌病理组织改变、心肌组织氧化应激及炎性因子、心肌凋亡情况.结果 与假手术相比,模型组平均动脉压(MAP)、左心室收缩压(LVSP)、心室内压下降最大速率(LV-dp/dtmax)、左心室内压上长最大速率(LV+dp/dtmax)、超氧化物歧化酶(SOD)活性、B细胞淋巴瘤/白血病-2(Bcl-2)蛋白水平均降低(P<0.05),左心室舒张末压(LVEDP)、丙二醛(MDA)、白介素-6(IL-6)、肿瘤坏死因子-ɑ(TNF-ɑ)水平、心肌细胞凋亡率、Bcl相关X蛋白(Bax)、cleaved-Caspase-3蛋白水平升高(P<0.05);与模型组相比,RSV组、RSV+尿激酶原组的MAP、LVSP、LV-dp/dtmax、LV+dp/dtmax、SOD活性、Bcl-2蛋白水平均升高(P<0.05),LVEDP、心肌组织相对梗死面积、LVEDP、MDA、IL-6、TNF-ɑ、心肌细胞凋亡率、Bax、cleaved-Caspase-3蛋白水平降低(P<0.05);与舒伐他汀组相比,RSV+尿激酶原组心肌组织相对梗死面积、MDA、IL-6、TNF-ɑ、心肌细胞凋亡率、Bax、cleaved-Caspase-3蛋白水平降低(P<0.05),SOD活性、Bcl-2蛋白水平升高(P<0.05).结论 尿激酶原联合RSV可以改善急性心肌梗死大鼠心肌梗死面积、改善血流动力学,降低心肌细胞凋亡.

患者女童,3岁,1年前无明显诱因左前臂突然出现一肿物,约"黄豆"大小,无明显压痛及叩击痛,后肿物缓慢增大.于当地医院就诊行局部肿物切除术,术后病理不详.2个月余前,原手术部位再次出现肿物,当地医院MRI示:左前臂前侧皮下软组织内异常信号,考虑软组织肿瘤,随后来我院就诊.

目的:探讨HIF-1α通过调节TP53INP1蛋白对乳腺癌细胞迁移及侵袭能力的影响.方法:通过免疫组化检测60例乳腺癌标本中TP53INP1和HIF-1α的表达情况及分析其临床病理资料.通过体外构建HIF-1α及共转染HIF-1α和TP53INP1细胞模型,迁移侵袭实验和划痕实验检测HIF-1α和TP53INP1对乳腺癌细胞迁移侵袭能力的影响;Western blot实验研究共同下调HIF-1α和TP53INP1对MMP2、VEGF蛋白表达水平的影响.结果:免疫组化实验显示HIF-1α在人乳腺癌组织中高表达,TP53INP1呈低表达,两者之间具有相关性且均与淋巴结转移有关(P<0.05).迁移侵袭实验及划痕实验显示在乳腺癌MDA-MB-231细胞和MCF-7细胞中下调HIF-1α抑制了迁移侵袭及愈合能力,MCF-7细胞中共同转染下调HIF-1α和TP53INP1质粒之后逆转了乳腺癌细胞的迁移侵袭能力及愈合能力(P<0.05).Western blot实验显示shHIF-1α和TP53INP1共转染后在MDA-MB-231细胞中MMP2表达水平高于下调HIF-1α表达组.共转染shHIF-1α和shTP53 INP1质粒后在MCF-7细胞中,VEGF和MMP2表达高于下调shHIF-1α组(P<0.05).结论:HIF-1α可能通过下调TP53INP1的表达促进乳腺癌细胞的迁移侵袭能力.

Background: Previous data suggested that dipeptidyl peptidase-IV (DPP4) involved in the occurrence of febrile seizure (FS), but its potential mechanism remains to be determined. Here, we investigated whether DPP4 regulated gamma-aminobutyric acid (GABA) mediated spontaneous inhibitory postsynaptic currents (sIPSCs) via the downstream C-X-C Motif Chemokine Ligand 12 (CXCL12)/ C-X-C chemokine receptor type 4 (CXCR4) signaling in cultured hippocampal neurons submitted to hyperthermia(39.5-40°C). Methods: Whole cell patch- clamp method was used to test sIPSC in vitro after DPP4 inhibition or CXCL12 administration. The level of CXCL12 and CXCR4 was tested using western blot analysis. The effect of CXCR4 antagonist AMD3100 (5 mg/ml, i.c.v) on seizures were tested using electroencephalogram (EEG) in a FS model. Results: We found that pharmacological DPP4 inhibitor sitagliptin (Sita,100μM) treatment or siRNA-mediated DPP4 knockdown enhanced the mean amplitude and frequency of sIPSCs in vitro. DPP4 knockdown with siRNA increased protein level of CXCL12 and CXCR4. Furthermore, CXCL12 (10 nM) treatment enhanced inhibitory transmission by increasing the mean frequency and amplitude of sIPSCs in vitro. AMD3100 administration decreased seizure severity by increasing hippocampal GABA content in vivo. Conclusions: Our data suggest that CXCL12/CXCR4 signaling is required for DPP4 regulation of sIPSCs, supporting that DPP4 played a key role in the pathogenesis of FS.

Enhancer of zeste homolog 2 (EZH2), a subunit of the polycomb repressive complex 2 (PRC2), is associated with seizure development and epileptogenesis, however, the underlying mechanism of the process remains to be elucidated. This study focused on exploring whether EZH2 regulated gamma-aminobutyric acid (GABA)-mediated neurotransmission during seizure generation. Hyperthermia-induced seizures were generated in Sprague-Dawley (SD) rats using a hot (43.5 °C) bath method, and seizure severity was evaluated according to the Racine scale. The effect of treatment with the EZH2 pharmacological inhibitor GSK 126 on the GABA and pro-inflammatory cytokine levels was tested using enzyme-linked immunosorbent assay (ELISA). Miniature inhibitory postsynaptic currents (mIPSCs) were recorded using whole-cell patch clamp. In this study, our results showed that intracerebroventricular (i.c.v) injection of the EZH2 pharmacological inhibitor GSK 126 (10 nM) increased seizure severity and shortened seizure latency in a rat model of FS, and these effects were accompanied by reduced GABA content. Furthermore, GSK 126 (1 μM) treatment decreased the mean amplitude and frequency of the mIPSCs in cultured hippocampal neurons subjected to hyperthermia. Importantly, the same results were also obtained in cultured neurons infected with lentivirus carrying EZH2 shRNA. In addition, a significant increase in the pro-inflammatory cytokine (IL-1β and TNF-α) levels was observed in rats after GSK 126 treatment, and IL-1β administration increased seizure severity, suggesting that the inflammatory response was involved in the regulation of seizure development by EZH2. This study helps clarify the role of EZH2 in FS and supports EZH2 administration as an effective target for the management of seizure generation.

Dipeptidyl peptidase-IV (DPP4) plays a key role in tumor development; however, its role in glioma pathogenesis has not been determined. Here, we aimed to investigate the expression pattern of DPP4 and explore the association between expression and patient prognosis in glioma. DPP4 levels were investigated using qRT-PCR, immunohistochemistry and western blot in a rat model of glioma and also in patient samples. The relationship between DPP4 levels, WHO pathological grade gliomas, and isocitrate dehydrogenase 1 and 2 (IDH1/2) status was assessed in patient samples. Our data indicated that DPP4 levels were markedly increased in a rat model of glioma (p < 0.05, p < 0.01) and aslo in patient samples. Furthermore, the elevation of DPP4 levels in the samples obtained from pateints was associated with the pathogical grade of glioma and the IDH1/2 status (p < 0.01, p < 0.001). High DPP4 levels decreased the survival probability of patients with low-grade glioma (LGG). The data from patient samples showed that DPP4 expression increased with the pathological grade. Increased expression of DPP4 could be a promising index for determining the prognosis of glioma.

单形性亲上皮性肠道T细胞淋巴瘤(monomorphic epitheliotropic intestinal T-cell lymphoma,MEITL)是一种临床较为罕见的外周T细胞淋巴瘤,多发生在亚裔地区[1].WHO(2016)淋巴造血系统将其独立出来并成为“单形性亲上皮性肠道T细胞淋巴瘤”,其临床表现多为腹痛、穿孔及腹部肿块[2].现报道我院收集的3例MEITL患者,探讨分析其临床病理及其免疫表型特征,以提高对该病的认识.

OBJECTIVE:This study aimed to investigate the role of glucagon-like peptide-1 (GLP-1)/GLP-1 receptor(R) signaling in the regulation of seizure susceptibility and to explore the potential mechanism in rats.METHODS:Hyperthermia-induced seizures in SD rats were generated using hot bath methods, and seizure severity was measured according to Racine scores and electroencephalogram (EEG). Protein levels of GLP-1 and GLP-1R in the brain tissues of rats were evaluated through ELISA, western blot analysis, and immunohistochemistry to explore the possible roles of each in FS. Neuronal excitability, spontaneous inhibitory postsynaptic currents (sIPSCs) and transient receptor potential cation channel subfamily V member 1(TRPV1) currents were tested using the patch-clamp method in cultured hippocampal neurons.RESULT:Significant decreases in the levels of GLP-1 and GLP-1R were observed in the hippocampi of rats compared to those in the control group. Furthermore, treatment with the GLP-1R pharmacological inhibitor exendin9-39 increased hyperthermia- induced seizure severity in rats and promoted neuronal firing activity in cultured neurons. Importantly, exendin9-39 and GLP-1R knockdown decreased the amplitude and frequency of sIPSCs in cultured neurons. In addition, GLP-1R knockdown elevated downstream TRPV1 expression and promoted capsaicin-induced TRPV1 function, which may regulate inhibitory neurotransmission to affect seizure susceptibility.CONCLUSION:The present study suggests that inhibition of GLP-1R signaling promotes seizure activity, which plays a key role in the pathogenesis of FS.

Objective To investigate the change of lecithin cholesterol aeyltransferase (LCAT ) in diabetic patients with acute coronary syndromes (ACS) and analysis the relationship between LACT and cardiovascular event . Methods A total of 399 subjects were enrolled in this study and divided into three groups :diabetes mellitus with ACS group (DM + ACS ,n= 179) ,diabetes mellitus without ACS group (DM ,n= 120) and healthy subjects selected from medical examination center as normal control group (NC ,n=100) .Clinical characteristics and biochemical index were gathered from all the subjects .LCAT level was tested by ELISA .Then according to LCAT levels ,DM + ACS group were further divided into three groups by tertiles :low tertile subgroup (27.46 ～ 35.25 mg/ml ,n= 55 ) ,middle tertile subgroup (35.26～ 43.06 mg/ml ,n= 67)and the high tertile subgroup (43.07 ～ 50.86 mg/ml ,n= 57) . The relationship between different levels of LCAT and cardiovascular events were analyzed .Multivariate linear regression was used to analysis the influencing factors for LACT . Results (1)The percentage of insulin ,aspirin and CCB treatment were higher in DM +ACS group than in DM group[141(78.77％ )vs 65 (54.17％ );179(100.00％ )vs 114(95.00％ );88(49.16％ )vs 40(33.33％ ) ,P<0.05] .The levels of WC , BMI ,FPG ,HbA1c ,TC and LDL-C were higher ,while HDL-C and LCAT were lower in DM + ACS group and DM group than in NC group .Meanwhile ,the FPG ,HbA1 c ,TC and LDL-C were higher ,HDL-C and LCAT were lower in DM +ACS group than in DM group(P<0.05 or P<0.01);(2) Along with the rise of LCAT levels ,FPG ,2 hPG ,HbA1c ,TC and TG were reduced and HDL-C were increased (P<0.05) . During 6 months ,the number of cardiovascular events were lower in middle tertile subgroup and high tertile subgroup than in low tertile subgroup (0.49 vs 0.83 vs 1.84 time/n ,P<0.01);(3) Multivariate linear regression analysis showed that age ,FPG ,HbA1c and HDL-C were influence factors for LCAT (P<0.05 or P<0.01) . Conclusion The LCAT level was reduced in diabetic patient ,especially in diabetic patients with ACS .LCAT level maybe a predictor of cardiovascular event in diabetic patients with ACS . Age ,FPG ,HbA1 c and HDL-C were influence factors for LCAT .

目的 探讨CT血管造影在经皮冠状动脉介入治疗慢性完全闭塞病变(CTO)的评估价值.方法 分析我院2014年6月-2016年12月收治210例CTO患者资料,根据术前评估方法的不同分为对照组与观察组.其中1 06例患者术前接受常规评估方法,纳入对照组;另1 04例患者术前接受CT血管造影评估,纳入观察组,比较两组患者手术成功情况、左室收缩功能、并发症,分析CTO回归特征.结果 观察组患者手术成率显著高于对照组(P＜0.05).术前两组患者左室室壁运动指数、左室射血分数比较差异无统计学意义(P＞0.05).术后,两组患者左室室壁运动指数、左室射血分数均有改变,其中观察组患者左室室壁运动指教较术前下降,且低于对照组(P＜0.05),左室射血分数较术前上升,且高于对照组(P＜0.05).观察组患者并发症发生率显著低于对照组(P＜0.05).闭塞段远端纤维帽形态不清晰、闭塞段近端分叉及闭塞段长度≥ 20mm是影响CTO介入失败的主要因素.结论 CT血管造影在经皮冠状动脉介入治疗慢性完全闭塞病变效果评估有重要作用,能显著提高经皮冠状动脉介入治疗成功率,改善心室功能,减少并发症,值得推荐使用.

Objective To investigate the level of interleukin-6 (IL-6) and the effect of valproic acid(VPA) administration on IL-6 promoter methylation, further to explore the epigenetic mechanism in febrile seizures. Methods Sprague-Dawley (SD) rats (21 day) were randomly divided into control group (n=12) and febrile seizure (FS) group (n=12), and seizures were generated using hot bath methods and evaluated by racine score and electroencephalogram (EEG). The IL-6 protein and mRNA levels were detected using ELISA and quantitative reverse transcription polymerase chain reaction (qRT-PCR), respectively.Rat C6 cell line was cultured and randomly divided into control, VPA(0.2 mol/L), hyperthermia(43.5 ℃, 1 h), hyperthermia (43.5 ℃, 1 h)+VPA (0.2 mol/L) groups.The methylation status of IL-6 promoter in FS rats and the effect of VPA on IL-6 methylation in C6 cell line were examined by bisulfite sequencing polymerase chain reaction (BSP) to determine the epigenetic regulation of IL-6 level in FS. Results Racine score and EEG results showed that the frequency and amplitude of neuronal discharge increased after hot water bath in rats, and the latency of convulsion was shorter.The expression levels of IL-6 mRNA and protein were significantly increased in Fs group compared with those in control group(mRNA: Control: 0.98±0.34; FS: 2.85±0.39, P<0.05; Protein: Control: (2 824.33±169.20)pg/ml; FS: (3 514.58±86.4)pg/ml, P<0.01). The methylation of IL-6 promoter in FS group (84% (21/25)) was lower than that in control group (100% (25/25)) (P<0.05). A significant increase in methylation of IL-6 promoter was observed in C6 cell line from VPA combined with hyperthermia (96% (24/25)) but no change was showed in that from VPA alone (100% (25/25)) compared with that from control(100% (25/25)). Conclusion IL-6 level is up-regulated in FS rats, and the hypomethylation or demethylation of the IL-6 promoter region might increase the IL-6 level.VPA administration can elevate its methylation level, which provides a strong experimental basis for the future study of the epigenetic mechanism in FS. Key words: Febrile seizures; Interleukin-6; DNA methylation; Valproic acid; Bisulfite sequencingpolymerase chain reaction

目的 探讨冠状动脉CT造影对冠状动脉慢性完全闭塞病变(CTO)冠脉介入治疗(PCI)成败的预测价值.方法 回顾性分析我院收治的250例CTO患者临床资料,按照年龄的大小分为青中年组与老年组,其中≤60岁者共126例,纳入青中年组;＞60岁者124例患者,纳入老年组.比较两组患者冠状动脉造影的血管特征、介入治疗情况、手术成功率、术前后超声心动图情况.结果 老年组三支病变及合并左主干病变支数多于青中年组(P＜0.05).青中年组左前降支、右冠状动脉病变多于老年组(P＜0.05).老年组患者靶血管迂曲和钙化发生率显著高于中青年患者(P＜0.05).老年组患者桡动脉入路率显著高于中青年组(P＜0.05),桡动脉+股动脉入路率显著低于中青年组(P＜0.05).指引导管直径、逆向导丝技术比较差异统计学意义(P＞0.05).两组患者手术成功率比较差异无统计学意义(P＞0.05).手术前后青中年组患者LVEDD比较差异无统计学意义(P＞0.05),LVEF高于术前(P＜0.05).手术前老年组患者LVEDD显著高于术后(P＜0.05),LVEF与术后比较差异无统计学意义(P＞0.05).术前,两组患者LVEDD比较差异无统计学意义(P＜0.05),老年组患者LVEF高于青中年组(P＜0.05).术后,青中年组LVEDD高于老年组(P＜0.05),LVEDD与老年组比较差异无统计学意义(P＞0.05).结论 冠状动脉CT造影可提高冠状动脉慢性完全闭塞病变PCI治疗成功率,明确病变部位,指导穿刺.

目的 探讨灯盏花素注射液对急性心肌梗死患者细胞免疫、红细胞免疫及体液免疫的影响.方法 将74例急性心肌梗死患者按随机数字表法分为两组,每组37例.对照组接受常规对症治疗,观察组在对症治疗基础上静脉滴注灯盏花素注射液治疗.比较两组患者的临床疗效、治疗前后的细胞免疫、红细胞免疫与体液免疫指标.结果 观察组总有效率显著高于对照组(P<0.05).治疗前两组患者细胞免疫、红细胞免疫与体液免疫指标比较差异均无统计学意义(P>0.05);治疗后两组均较治疗前显著改善(P<0.05),观察组显著优于对照组(P<0.05).结论 灯盏花素注射液对急性心肌梗死患者细胞免疫、红细胞免疫及体液免疫的影响更为积极,对于综合免疫状态的调节作用突出,应用价值较高.

目的 探讨血清炎性指标和脂类指标在冠状动脉粥样硬化性心脏病患者中随病情进展水平及关系.方法 收集南阳市中心医院2013年3月-2017年3月收治的334例冠状动脉粥样硬化性心脏病患者,根据冠状动脉SYNTAX评分分为高危组87例、中危组115例,低危组132例.采用酶联免疫吸附法检测MCP-1、RANTES、CTRP1、ox-LDL水平,循环酶法检测HCY水平,免疫透射比浊法检测Lp(α)水平,分析冠状动脉粥样硬化性心脏病患者血清炎性指标与血脂指标水平变化及相关性.结果 冠状动脉粥样硬化性心脏病高危组血清MCP-1、RANTES、CTRP1水平明显高于中危组和低危组(P＜0.05);中危组血清MCP-1、RANTES、CTRP1水平高于低危组(P＜0.05).冠状动脉粥样硬化性心脏病高危组血清Lp(α)、HCY、ox-LDL水平明显高于中危组和低危组(P＜0.05);中危组血清Lp(α)、HCY、ox-LDL水平高于低危组(P＜0.05).经Pearson检验,血清MCP-1、RANTES、CTRP1水平与血清Lp(α)、HCY、ox-LDL水平呈显著相关性(P＜0.05).结论 血清新型炎性指标和脂类指标在冠状动脉粥样硬化性心脏病患者中随病情进展水平不断升高,两者间呈显著相关性,对冠状动脉粥样硬化性心脏病危险程度判断具有一定的指导意义.

目的:观察稳心颗粒联合倍他乐克对冠状动脉粥样硬化性心脏病心力衰竭合并室性早搏患者的临床疗效及对血浆N-末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)水平的影响.方法:选取80例冠状动脉粥样硬化性心脏病心力衰竭合并室性早搏患者,随机分为观察组与对照组,各40例.两组患者均行常规西医治疗,对照组患者加用倍他乐克,观察组在对照组基础上服用稳心颗粒治疗,两组均连续治疗3个月,比较治疗前后两组患者心脏功能指标及NYHA心功能分级、血浆NT-proBNP及血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)水平、中医证候积分、心电图QT间期离散度(QT dispersion,QTd)和JT间期离散度(JT dispersion,JTd).结果:两组患者治疗前后左室射血分数、左室收缩末期内径、左室舒张末期内径、E峰与A峰比值E/A、6分钟步行试验差异显著,且治疗后观察组优于对照组,差异具有统计学意义(P＜0.05);两组患者治疗前后NYHA心功能分级为Ⅱ级、Ⅲ级、Ⅳ级人数比较,差异有统计学意义(P＜0.05),治疗后观察组Ⅱ级、Ⅲ级、Ⅳ级人数分别为31例、7例、2例,对照组Ⅱ级、Ⅲ级、Ⅳ级人数分别为26例、10例、4例,两组比较,差异有统计学意义(P＜0.05);两组患者治疗前后血浆NT-proBNP、AngⅡ水平差异显著,且治疗后观察组分别为(312.65±67.75) ng·L-1、(248.67±53.66) ng·L-1,低于对照组的(369.77±78.54) ng·L-1、(297.73±60.32)ng·L-1,两组比较,差异有统计学意义(P＜0.05);两组患者治疗前后舌质、舌苔、脉象中医证候积分比较,差异无统计学意义(P＞0.05),心悸、气喘、气短、下肢水肿、畏寒肢冷、口唇紫绀等中医证候积分比较,差异显著,且治疗后观察组显著低于对照组,差异有统计学意义(P＜0.05);两组患者治疗前后QTd、JTd差异显著,且治疗后观察组显著低于对照组,差异有统计学意义(P＜0.05).结论:稳心颗粒联合倍他乐克能显著降低冠状动脉粥样硬化性心脏病心力衰竭合并室性早搏患者NT-proBNP、AngⅡ水平,改善心脏功能,在缓解临床症状的同时缩短QTd、JTd,改善室性早搏.