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Relationship Between Insulin Resistance and Adiponectin in Salt Sensitive Hypertensive Patients

目的:探討鹽敏感性高血壓患者胰島素抵抗與脂聯素代謝異常的關系。方法:對100例高血壓患者采用急性鹽水負荷試驗,確定65例為鹽敏感性(SS)高血壓患者,35例為鹽不敏感性(NSS)高血壓患者,選定正常人50例為對照組,分別測其胰島素水平、血脂、血尿酸及脂聯素水平。結果:高血壓患者存尿酸、膽固醇、甘油三酯水平升高(Plt;0.01),SS組較NSS組的血尿酸、血膽固醇、血甘油三脂增高(Plt;0.01)。SS組脂聯素［(6.04±2.08)ng/mL］,較NSS組［(7.89±3.35)ng/mL(Plt;0.01)］降低,且SS組存在胰島素抵抗,HOMA指數分別為［2.54±0.53,2.21±0.55(Plt;0.01)］。血漿脂聯素水平與胰島素抵抗指標存在正相關,r=-0.36,(Plt;0.01)。結論:鹽敏感性高血壓患者存在胰島素抵抗及脂聯素降低,胰島素抵抗可能是其他代謝異常及脂聯素降低的基礎。

The interpretation of antihypertensive drugs rational use guideline: RAAS inhibitors for hypertension complications

Significance of Expression of Platelet Derived Growth Factor and Survivin of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Objective　To investigate the expressions of platelet derived growth factor (PDGF) and survivin in hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) and to evaluate the relationships among the expressions of PDGF, survivin and the proliferation of cancer cells. Methods　The expression of PDGF mRNA in 16 cases in HCC with PVTT group was observed by in situ hybridization and the results were compared with that in HCC tissue group. The expressions of PDGF and survivin protein in 36 cases in HCC with PVTT group were detected with immunohistochemistry and it was found that there was a correlation between them. Flow cytometry (FCM) was used to measure the proliferation of cancer cells and it was also used to analyze the relations among PDGF, survivin and the proliferation of cancer cells. Results　The expression level of PDGF mRNA in HCC with PVTT group was significantly higher than that in HCC tissue group (P＜0.01). There was a positive correlation between the expressions of PDGF and survivin protein in HCC with PVTT (P＜0.01). The degree of proliferation of cancer cells in PDGF and survivin protein positive group was significantly higher than that in negative group (P＜0.01). Conclusion　PDGF and survivin gene over-expressed in HCC with PVTT group and there is a positive correlation between the expressions of PDGF and survivin protein. The proliferation of cancer cells increases as the expressions of PDGF and survivin increase.

THE ALTERNATION OF AFP-mRNA DETECTED IN BLOOD DURING LIVER RESECTION FOR HEPATOCELLULAR CARCINOMA AND ITS SIGNIFICANCE

【Abstract】Objective To investigate whether liver resection for hepatocellular carcinoma (HCC) causes dissemination of liver tumor cells into blood circulation. Methods Fourteen patients with HCC, but without evidences of metastasis, were enrolled for the study. Blood samples of peripheral blood before skin incision and after abdominal wall suture, and of hepatic venous blood and portal venous blood after liver parenchyma dissection, were obtained. AFPmRNA was detected by reverse transcription polymerase chain reaction assays, the change of the level of its expression during operation was assessed by semi-quantitative analysis. Results The rate of its expression before and after operation in peripheral blood, and during operation in portal venous blood and in hepatic venous was 42.9%, 35.7%, 42.9% and 57.1% respectively. There were no differences between them. However, the level of its expression in hepatic venous blood was significantly higher than others (P＜0.05). Conclusion Liver resection for HCC induces releases of cells from the liver, probably including tumor cells, into blood circulation.

Analysis of the characteristics of thromboembolic events in patients with hypertrophic cardiomyopathy

ObjectiveTo analyze the clinical characteristics of thrombo embolism (TE) in Chinese hypertrophic cardiomyopathy (HCM) patients. MethodsThis study retrospectively analyzed HCM patients admitted to West China Hospital of Sichuan University. The endpoints were defined as a composite of TE events, including ischemic stroke, transient ischemic attack, and peripheral arterial embolization. ResultsA total of 537 HCM patients were included with a median follow-up of 4.2 years. Forty-two patients reached the TE endpoint and the incidence was 1.9%. The annual incidence of TE was approximately 1.1% and 6.6% for HCM patients without/with atrial fibrillation, respectively. The recurrence rate of TE was high (approximately 26.2%). The mean age was 66.4±13.7 years for the first TE, and the incidence of TE was significantly increased at age ≥70 years. ConclusionThe incidence of TE is high in HCM patients, especially in those with atrial fibrillation, and the recurrence rate of TE is also high.

A New Tool for Medical Research ——ATP-Binding Cassette Transporter Families

Objective 　To review the application advancements of ATP-binding cassette (ABC) transporter in medical research.Methods 　Relevant literatures about the applications of ABC families in medical research were reviewed. Results 　ABC families mainly took roles in transporting substances across cell membrane. Some of them were useful for the prediction of drug resistance and the prognosis of malignant tumors. Others were target s for molecular researches. Their expressions or mutations might be related with the occurrence of diseases. Conclusion ABC families are very important in the diagnosis and therapy for diseases. Thus they are very promising tools for future medical research.

Significance of Vascular Endothelial Growth Factor Expression on Portal Vein Tumor Thrombus of Hepatocellular Carcinoma

ObjectiveTo explore the relation between vascular endothelial growth factor （VEGF） and the formation of tumor thrombosis in the main trunks of portal vein (PVTT). MethodsTumor specimens were collected from 36 patients (16 patients with PVTT, the other patients without PVTT and metastasis) undergoing resection of hepatocellular carcinoma (HCC) and portal thrombectemy, PVTT specimens of 16 patients named group A1, the same patients’ with HCC named group A2, tumor specimens of the other patients named group B. In situ hybridization and immunohistochemistry were used to investigate VEGF mRNA, protein and microvessel density (MVD) on surgical specimens. The intensity was evaluated using a computer image analyzercell analysis system.ResultsVEGF mRNA expression was detected in the tumor’ cell of the specimens. The expression rates of VEGF mRNA in the group B, A2, A1 were 30%, 100%, 100% respectively, and the expression rates of VEGF mRNA in group A2 and A1 were higher than that in group B （P＜0.01）. The intensity of VEGF mRNA in group A2 （0.078 5±0.019 6） were lower than in group A1 （0.194 4±0.059 0） （P＜0.01）. VEGF protein expression was often detected in the tumor cell, vascular endothelial cell and fibroblast cells. Invasion was detected in small vein in group A2, more tumor cell colony detected in group A1. The expression rates of VEGF protein in group B, A2, A1 were same as VEGF mRNA; the intensity of VEGF protein in A1 （0.165 6± 0.034 5） was higher than in group A2 （0.108 1±0.024 3） （P＜0.01）. MVD in group B, A2, A1 was 31.9±14.4, 63.3±15.1, 116±27.6/view of 200 microscopefield, MVD in group A1 was higher than group A2 （P＜0.01）, higher in group A2 than in group B. There was a statistically significant correlation between the intensity of VEGF expression and MVD in group B,A2 and A1. ConclusionVEGF could play an important role in the invasion, metastasis of HCC and the formation of PVTT. Angiogenesis in tumor is correlated well with the progression of HCC.

Changes of Thyroid Hormone Receptor Activity in Patients with Hypertensive Non-valvular Atrial Fibrillation

目的　研究高血壓非瓣膜心房顫動患者甲狀腺激素受體（TR）的活性差異，以探討此類患者心房顫動發生發展的可能機制。 方法　2008年1月－2010年1月序貫收集103例高血壓非瓣膜心房顫動患者的相關資料（48例陣發性心房顫動、55例持續性心房顫動），并收集50例單純高血壓患者。收集各組患者的相關人口學數據及檢查結果，并采用放射性分析技術測定各組患者外周血淋巴細胞及淋巴細胞核TR的活性，主要包括平衡解離常數（Kd）及最大結合容量（MBC）。 結果　心房顫動患者淋巴細胞TR的Kd較單純高血壓患者小（越小表示與甲狀腺激素的親和力越高），且持續性心房顫動患者的Kd較陣發性心房顫動患者更小（0.77 ± 0.43、1.02 ± 0.41，P＜0.001）；心房顫動患者淋巴細胞TR的MBC較單純高血壓患者小(越小表示受體總量越少)，且持續性心房顫動患者TR的MBC較陣發性心房顫動患者更小（36.10 ± 12.40、65.22 ± 30.90，P＜0.001）。淋巴細胞核TR的Kd及MBC也存在類似情況。簡單相關分析提示左房直徑與淋巴細胞TR的Kd及MBC呈負相關，另外，調整相關指標后偏相關分析也提示左房直徑與Kd及MBC呈負相關（Kd：r=?0.296，MBC：r=?0.448；P均＜0.01）；淋巴細胞核TR的Kd及MBC也存在類似情況。 結論　高血壓非瓣膜心房顫動患者中，TR的總量減少，并且持續心房顫動組低于陣發心房顫動組；甲狀腺激素與受體的親和力在心房顫動患者中升高，且持續心房顫動組高于陣發心房顫動組。另外，還發現TR的Kd和MBC與左房直徑均呈負相關。這些改變可能是高血壓非瓣膜心房顫動患者心房顫動發生及維持的一種重要機制。

Study on the Relationship between Waist to Height Ratio and Blood Pressure, Serum Lipid and Blood Glucose in Middle and Old-aged Population in Chengdu City

目的　探討成都地區中老年人群的腰高比值（WHtR）與血壓、血脂、血糖的關系。 方法　2007年5月間在成都市地中老年人群（688人）中用統一編制的調查表記錄被調查者的血壓、血脂、血糖、WHtR等指標，并用相關統計學數據進行分析。 結果　① 成都地區中老年人群WHtR≥0.5的高血壓、高血脂、高血糖的發病率明顯高于對照組（P＜0.05），且有統計學意義。② 年齡、收縮壓、舒張壓、甘油三酯和血糖水平，WHtR≥0.5組明顯高于WHtR＜0.5組，而WHtR≥0.5組高密度脂蛋白水平低于WHtR＜0.5組，且組間差異均有統計學意義。③ logistic 回歸分析表明WHtR與年齡、收縮壓、舒張壓、甘油三酯、空腹血糖水平呈正相關，與高密度脂蛋白水平呈負相關。 結論　成都地區中老年人群WHtR與血壓、血脂及血糖關系密切，可能可以通過改善血壓、血脂、空腹血糖等指標來減少WHtR，中老年人群要加強對 WHtR 的自我管理, 盡可能將心血管疾病危險因素降到最低。

Research on the relationship between a body shape index and abnormal inflammation

Objective To investigate the relationship between a body shape index (ABSI) and abnormal inflammation. Methods In May 2007, a cross-sectional study was conducted among 651 individuals by random sampling method in an urban community located in Chenghua district of Chengdu. We mainly assessed the relationship between ABSI and abnormal inflammation, which was defined as high sensitive C-reactive protein equal to 3 mg/L or higher. Results Logistic regression analysis showed that body mass index (BMI), waist circumference (WC) and ABSI were independently associated with abnormal inflammation. For identifying abnormal inflammation, WC had the best discriminatory power with the area under the receiver operating characteristic curve (AROC) was 0.627 [95% CI (0.564, 0.689)], followed by BMI (AROC: 0.609) and ABSI (AROC: 0.608). In addition, combination with ABSI could improve the discriminatory power of BMI for abnormal inflammation, and AROC increased from 0.609 to 0.646. Combination with ABSI could also improve the discriminatory power of WC for abnormal inflammation, and AROC only increased from 0.627 to 0.631. Conclusions In the general Chinese population, ABSI is independently associated with abnormal inflammation, but the discriminatory power is poor, no better than BMI and WC. Furthermore, combination with ABSI can improve the discriminatory power of BMI and WC for abnormal inflammation, especially for BMI. Further studies about ethnic specificities of ABSI are needed.