• 【缓慢失活的钙电流在分泌降钙素的细胞中充当钙传感器。】 复制标题 收藏 收藏
    DOI:10.1016/0014-5793(90)81048-s 复制DOI
    作者列表:Scherübl H,Schultz G,Hescheler J
    BACKGROUND & AIMS: :Calcitonin (CT)-secreting cells (C-cells) are remarkably sensitive to changes in the extracellular Ca2+ concentration. In order to detect the mechanism by which C-cells monitor Ca2+, we compared a C-cell line responding to Ca2+ (rMTC cells) with another one known to have a defect in this Ca2+ signal transduction (TT cells). Rises of the Ca2+ concentration caused rMTC cells to depolarize and/or elicited spontaneous action potentials. Under voltage-clamp conditions, rMTC cells showed a slowly decaying Ca2+ inward current which was sensitive to dihydropyridines but not to Ni2+ at a low concentration. In contrast, the 'defective' TT cells neither depolarized nor fired action potentials with high Ca2+; they only exhibited an Ni2(+)-sensitive, transient Ca2+ current. The data strongly suggest that the slowly inactivating Ca2+ current is a prerequisite for Ca2(+)-sensitivity of C-cells and that fast inactivating channels are not sufficient to act as sensors of the extracellular Ca2+ concentration.
    背景与目标: :分泌降钙素(CT)的细胞(C细胞)对细胞外Ca2浓度的变化非常敏感。为了检测C细胞监测Ca2的机制,我们将响应Ca2的C细胞系(rMTC细胞)与已知在Ca2信号转导中存在缺陷的另一种细胞(TT细胞)进行了比较。 Ca 2浓度的升高引起rMTC细胞去极化和/或引起自发动作电位。在电压钳制条件下,rMTC细胞显示出缓慢衰减的Ca2内向电流,该电流对二氢吡啶敏感,但对低浓度的Ni2不敏感。相反,“缺陷”的TT细胞既没有去极化也没有激发具有高Ca2的动作电位。它们仅表现出对Ni2()敏感的瞬态Ca2电流。数据强烈表明,缓慢失活的Ca2电流是C细胞对Ca2()敏感性的先决条件,而快速失活的通道不足以充当细胞外Ca2浓度的传感器。
  • 【MacMARCKS与7型代谢型谷氨酸受体相互作用,并调节G蛋白介导的钙通道组成型抑制。】 复制标题 收藏 收藏
    DOI:10.1111/j.1471-4159.2006.04121.x 复制DOI
    作者列表:Bertaso F,Lill Y,Airas JM,Espeut J,Blahos J,Bockaert J,Fagni L,Betz H,El-Far O
    BACKGROUND & AIMS: :We have previously shown that the interaction of Ca2+/calmodulin with the metabotropic glutamate receptor type 7 (mGluR7) promotes the G-protein-mediated inhibition of voltage-sensitive Ca2+ channels (VSCCs) seen upon agonist activation. Here, we performed a yeast two-hybrid screen of a new-born rat brain cDNA library using the cytoplasmic C-terminal tail of mGluR7 as bait and identified macrophage myristoylated alanine-rich c-kinase substrate (MacMARCKS) as a binding protein. The interaction was confirmed in vitro and in vivo by pull-down assays, immunoprecipitation, and colocalization of mGluR7 and MacMARCKS in transfected HEK293 cells and cultured cerebellar granule cells. Binding of MacMARCKS to mGluR7 was antagonized by Ca2+/calmodulin. In neurons, cotransfection of MacMARCKS with mGluR7, but not mGluR7 mutants unable to bind MacMARCKS, reduced the G-protein-mediated tonic inhibition of VSCCs in the absence of mGluR7 agonist. These results suggest that competitive interactions of Ca2+/calmodulin and MacMARCKS with mGluR7 control the tonic inhibition of VSCCs by G-proteins.
    背景与目标: :我们以前已经证明,Ca2 /钙调蛋白与7型代谢型谷氨酸受体(mGluR7)的相互作用促进了激动剂激活后G蛋白介导的对电压敏感Ca2通道(VSCC)的抑制。在这里,我们使用mGluR7的胞质C末端尾巴作为诱饵,对新生大鼠大脑cDNA文库进行了酵母双杂交筛选,并鉴定了巨噬细胞肉豆蔻酰化的富含丙氨酸的c激酶底物(MacMARCKS)作为结合蛋白。通过下拉测定,免疫沉淀以及mGluR7和MacMARCKS在转染的HEK293细胞和培养的小脑颗粒细胞中的共定位,在体外和体内证实了这种相互作用。 Ca2 /钙调蛋白可拮抗MacMARCKS与mGluR7的结合。在神经元中,将MacMARCKS与mGluR7共转染,但不能与不能结合MacMARCKS的mGluR7突变体共转染,可在不存在mGluR7激动剂的情况下减少VSCC的G蛋白介导的强直抑制作用。这些结果表明Ca2 /钙调蛋白和MacMARCKS与mGluR7的竞争性相互作用控制了G蛋白对VSCC的强直抑制。
  • 【正常年轻妇女和老年妇女的肠道维生素D受体,钙吸收与血清1,25二羟基维生素D之间的关联。】 复制标题 收藏 收藏
    DOI:10.1359/jbmr.1997.12.6.922 复制DOI
    作者列表:Kinyamu HK,Gallagher JC,Prahl JM,DeLuca HF,Petranick KM,Lanspa SJ
    BACKGROUND & AIMS: The exact mechanism for the decrease in intestinal calcium absorption with age is not yet understood. A decrease with age in serum 1,25-dihydroxyvitamin D (1,25(OH)2D) or a decrease in the intestinal vitamin D receptor (VDR) protein concentration are possible causes. The objective of this study was to examine the effect of age on these factors. Fifty-nine young women age 25-35 years were compared with 41 elderly women age 65-83 years who underwent measurements of VDR, calcium absorption using a 20 mg and 100 mg calcium carrier, and calciotropic hormones. Calcium absorption by both tests was lower in the elderly women compared with the young women (p < 0.05). Serum 1,25(OH)2D and duodenal VDR protein concentration were not significantly different between the two age groups. Serum 1,25(OH)2D correlated with the 20 mg calcium absorption test in both young (r = 0.35, p < 0.007) and elderly women (r = 0.58, p < 0.0001) and with the 100 mg calcium absorption in the elderly (r = 0.32; p < 0.05). VDR did not correlate with calcium absorption in young women or elderly women, nor did VDR correlate with serum 1,25(OH)2D and serum 25-hydroxyvitamin D. In summary, the decrease in calcium absorption cannot be explained by a decrease in intestinal VDR. The correlation between serum 1,25(OH)2D and both calcium absorption tests only accounts for 12-30% of the variance in the age-related change in the calcium absorption tests. Other factors, not yet understood, are responsible for the decline in calcium absorption with age.

    背景与目标: 随着年龄的增长,肠道钙吸收减少的确切机制尚不清楚。血清1,25-二羟基维生素D(1,25(OH)2D)随年龄的减少或肠道维生素D受体(VDR)蛋白质浓度的减少是可能的原因。这项研究的目的是研究年龄对这些因素的影响。比较了59名年龄在25-35岁之间的年轻女性与41位年龄在65-83岁之间的女性,这些女性进行了VDR测量,使用20 mg和100 mg钙载体的钙吸收量以及亲钙性激素。与年轻女性相比,老年女性的两种测试中的钙吸收均较低(p <0.05)。在两个年龄组之间,血清1,25(OH)2D和十二指肠VDR蛋白浓度无显着差异。血清1,25(OH)2D与年轻(r = 0.35,p <0.007)和老年妇女(r = 0.58,p <0.0001)的20 mg钙吸收测试以及老年人的100 mg钙吸收相关(r = 0.32; p <0.05)。 VDR与年轻妇女或老年妇女的钙吸收无关,也不与血清1,25(OH)2D和血清25-羟维生素D相关。 VDR。血清1,25(OH)2D与两种钙吸收试验之间的相关性仅占钙吸收试验中与年龄相关的变化方差的12%至30%。钙吸收随着年龄的增长而下降的其他原因尚不明确。

  • 【N1-苄基-N2- [1-(1-萘基)乙基]-反式1,2-二氨基环己烷:4-氯苯基羧酰胺(calhex 231)的开发作为一种新型的钙感应受体配体,具有强大的钙分解活性。】 复制标题 收藏 收藏
    DOI:10.1021/jm051233+ 复制DOI
    作者列表:Kessler A,Faure H,Petrel C,Rognan D,Césario M,Ruat M,Dauban P,Dodd RH
    BACKGROUND & AIMS: :A structure-activity relationship (SAR) study was performed principally at the N1 position of N1-arylsulfonyl-N2-[1-(1-naphthyl)ethyl]-trans-1,2-diaminocyclohexanes, a new family of calcilytics acting at the calcium sensing receptor (CaSR). The most active compound in this series was the 4-(trifluoromethoxy)benzenesulfonyl derivative 7e, which displayed an IC50 of 5.4 +/- 0.5 microM with respect to the inhibition of calcium-induced tritiated inositol phosphate ([3H]IP) accumulation in Chinese hamster ovarian (CHO) cells expressing the CaSR. Replacement of the sulfonamide linkage of this compound by a carboxamide led to a 6-fold increase in activity (7m, IC50 = 0.9 +/- 0.2 microM). Among the carboxamides synthesized, one of the most active compounds was the 4-chlorophenylcarboxamide (1S,2S,1'R)-7n (Calhex 231, IC50 = 0.33 +/- 0.02 microM). The absolute configuration of (1S,2S,1'R)-7n was deduced from an X-ray crystallographic study of one of the diastereomers of compound 7d. The stereochemical preference for the (1S,2S,1'R)-isomers can be rationalized on the basis of a three-dimensional model of the calcilytic binding pocket of the CaSR. Removal of the C-1' methyl group or replacement of the 1-naphthyl group by a 2-naphthyl or biphenyl moiety led to appreciable loss of calcilytic activity. Compounds 7e, 7m, and Calhex 231 did not stimulate [3H]IP accumulation in CHO cells expressing or not expressing the CaSR.
    背景与目标: :结构-活性关系(SAR)研究主要在N1-芳基磺酰基-N2- [1-(1-(萘基)乙基]-反式-1,2-二氨基环己烷的N1位置进行,钙敏感受体(CaSR)。该系列中活性最高的化合物是4-(三氟甲氧基)苯磺酰基衍生物7e,在抑制中国仓鼠中钙诱导的tri化肌醇磷酸酯([3H] IP)积累方面,其IC50为5.4 /-0.5 microM。表达CaSR的卵巢(CHO)细胞。该化合物的磺酰胺键被羧酰胺取代导致活性增加了6倍(7m,IC50 = 0.9 /-0.2 microM)。在合成的羧酰胺中,活性最高的化合物之一是4-氯苯基羧酰胺(1S,2S,1'R)-7n(Calhex 231,IC50 = 0.33 /-0.02 microM)。 (1S,2S,1'R)-7n的绝对构型是由化合物7d的一种非对映异构体的X射线晶体学研究得出的。 (1S,2S,1'R)异构体的立体化学偏好可以根据CaSR钙解结合口袋的三维模型来合理化。除去C-1'甲基或用2-萘基或联苯部分取代1-萘基导致明显的钙解活性损失。化合物7e,7m和Calhex 231不会刺激表达或不表达CaSR的CHO细胞中的[3H] IP积累。
  • 【血液透析患者的钙敏感受体基因型和对Cinacalcet的反应。】 复制标题 收藏 收藏
    DOI:10.2215/CJN.11141016 复制DOI
    作者列表:Moe SM,Wetherill L,Decker BS,Lai D,Abdalla S,Long J,Vatta M,Foroud TM,Chertow GM
    BACKGROUND & AIMS: BACKGROUND AND OBJECTIVES:We tested the hypothesis that single nucleotide polymorphisms (SNPs) in the calcium-sensing receptor (CASR) alter the response to the calcimimetic cinacalcet. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:We analyzed DNA samples in the Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) trial, a randomized trial comparing cinacalcet to placebo on a background of usual care. Of the 3883 patients randomized, 1919 (49%) consented to DNA collection, and samples from 1852 participants were genotyped for 18 CASR polymorphisms. The European ancestry (EA; n=1067) and African ancestry (AfAn; n=405) groups were assessed separately. SNPs in CASR were tested for their association with biochemical measures of mineral metabolism at baseline, percent change from baseline to 20 weeks, and risk of clinical fracture as dependent variables. RESULTS:There were modest associations of CASR SNPs with increased baseline serum parathyroid hormone and bone alkaline phosphatase primarily with the minor allele in the EA group (all P≤0.03), but not in the AfAn sample. In contrast, there was a modest association of decreased baseline serum calcium and FGF23 with CASR SNPs (P=0.04) primarily with the minor allele in the AfAn but not in the EA sample. The minor allele of two SNPs was associated with decreased percent reduction in parathyroid hormone from baseline to 20 weeks in the EA population (P<0.04) and this was not altered with cinacalcet. In both EA and AfAn, the same SNP (rs9740) was associated with decreased calcium with cinacalcet treatment (EA and AfAn P≤0.03). Three SNPs in high linkage disequilibrium were associated with a higher risk of clinical fracture that was attenuated by cinacalcet treatment in the EA sample (P<0.04). CONCLUSIONS:These modest associations, if validated, may provide explanations for differences in CKD-mineral bone disorder observed in EA and AfAn populations, and for differential biochemical responses to calcimimetics.
    背景与目标: 背景与目的:我们检验了钙敏感受体(CASR)中的单核苷酸多态性(SNP)改变对拟钙剂西那卡塞的反应的假说。
    设计,地点,参与者和测量:我们在Cinacalcet HCl降低心血管事件治疗评估(EVOLVE)试验中分析了DNA样品,该试验是在常规护理的背景下将cinacalcet与安慰剂进行比较的随机试验。在3883名随机分组的患者中,有1919名(49%)同意收集DNA,并对来自1852名参与者的样本进行了18种CASR多态性的基因分型。欧洲血统(EA; n = 1067)和非洲血统(AfAn; n = 405)分别进行了评估。测试了CASR中的SNP与基线时矿物质代谢的生化指标,从基线到20周的变化百分数以及临床骨折风险为因变量的相关性。
    结果:在EA组中,CASR单核苷酸多态性与基线血清甲状旁腺激素和骨碱性磷酸酶升高之间存在适度的相关性,主要与次要等位基因相关(均P≤0.03),而在AfAn样品中则没有。相反,基线血清钙和FGF23降低与CASR SNPs(P = 0.04)之间存在适度的联系,主要与AfAn中的次要等位基因有关,而与EA样品中无关。在EA人群中,两个SNP的次要等位基因与甲状旁腺激素从基线降低到20周的百分比降低有关(P <0.04),而西那卡塞不变。在EA和AfAn中,相同的SNP(rs9740)与西那卡塞治疗引起的钙降低有关(EA和AfAnP≤0.03)。高连锁不平衡中的三个SNP与EA样品中的西那卡塞特治疗减弱的临床骨折风险较高相关(P <0.04)。
    结论:这些适度的关联性如果得到验证,则可以解释EA和AfAn人群中CKD矿物骨骼疾病的差异,以及对拟钙剂的不同生化反应。
  • 【CHADS2评分与阵发性房颤患者抗心律失常药物治疗疗效之间的关系。】 复制标题 收藏 收藏
    DOI:10.1253/circj.cj-12-0854 复制DOI
    作者列表:Komatsu T,Sato Y,Ozawa M,Kunugita F,Ueda H,Tachibana H,Morino Y,Nakamura M
    BACKGROUND & AIMS: BACKGROUND:The Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled] (CHADS(2)) score is a useful scheme for risk stratification of thromboembolism patients, but there is little information about its usefulness for the evaluation of antiarrhythmic drug (AAD) therapy. METHODS AND RESULTS:This study included 459 paroxysmal atrial fibrillation (AF) patients (309 men, mean age 66 ± 12 years, mean follow-up 50 ± 35 months) and prophylactic efficacy was analyzed on the basis of CHADS(2) score. (1) Survival rates free from AF recurrence at 1, 6, 12 and 24 months were, respectively, 89%, 74%, 63% and 47% in score-0 group (n=152); 92%, 68%, 59% and 48% in score-1 group (n=158); 86%, 64%, 56% and 46% in score-2 group (n=84); 81%, 65%, 51% and 35% in score-3 group (n=43); and 68%, 50%, 36% and 18% in ≥ score-4 group (n=22) (P<0.05; score-0, score-1 or score-2 vs. ≥ score-4 group). (2) Survival rates free from progression to chronic AF at 12, 36, 60 and 90 months were, respectively, 95%, 93%, 91% and 89% in score-0 group; 97%, 91%, 89% and 88% in score-1 group; 96%, 93%, 88% and 83% in score-2 group; 91%, 74%, 67% and 60% in score-3 group; and 91%, 82%, 68% and 55% in ≥ score-4 group (P<0.01; score-0, score-1 or score-2 vs. ≥ score-4 group). (3) In multivariate logistic regression analysis adjusted for potentially confounding variables, CHADS(2) score was associated with AF recurrence (odds ratio [OR] 1.45, 95% confidence interval [CI] 1.16-1.81, P<0.001), and progression to chronic AF during AAD therapy (OR 1.64, 95% CI 1.04-2.69, P<0.001). CONCLUSIONS:When using a rhythm control strategy, the CHADS(2) score is a useful scheme for predicting the outcome of AAD treatment of patients with paroxysmal AF.  
    背景与目标: 背景:心脏衰竭,高血压,年龄,糖尿病,中风[加倍](CHADS(2))评分是对血栓栓塞患者进行风险分层的有用方案,但有关其对抗心律不齐药物(AAD)评估的有用性的信息很少) 治疗。
    方法与结果:这项研究纳入459例阵发性房颤(AF)患者(309名男性,平均年龄66±12岁,平均随访50±35个月),并根据CHADS(2)评分分析了其预防性疗效。 (1)得分为0的组在1、6、12和24个月无房颤复发的生存率分别为89%,74%,63%和47%(n = 152);得分1组(n = 158)为92%,68%,59%和48%;得分2组分别为86%,64%,56%和46%(n = 84);得分3组(n = 43)分别为81%,65%,51%和35%; ≥4分组(n = 22)分别为68%,50%,36%和18%(P <0.05; 0分,1分或2分与≥4分组比较)。 (2)在0级评分组中,在12、36、60和90个月无进展为慢性房颤的生存率分别为95%,93%,91%和89%;得分1组分别为97%,91%,89%和88%;得分2组分别为96%,93%,88%和83%;分数3组的比例分别为91%,74%,67%和60%; ≥4分组分别为91%,82%,68%和55%(P <0.01; 0分,1分或2分与≥4分组比较)。 (3)在针对潜在混杂变量进行调整的多因素logistic回归分析中,CHADS(2)评分与房颤复发相关(几率[OR] 1.45、95%置信区间[CI] 1.16-1.81,P <0.001)和进展到AAD治疗期间的慢性房颤(OR 1.64,95%CI 1.04-2.69,P <0.001)。
    结论:使用节律控制策略时,CHADS(2)评分是预测阵发性房颤患者AAD治疗结果的有用方案。
  • 【核苷酸(t)ide模拟疗法对慢性乙型肝炎患者肝癌发生的影响:倾向评分分析。】 复制标题 收藏 收藏
    DOI:10.1016/j.jhep.2012.10.025 复制DOI
    作者列表:Kumada T,Toyoda H,Tada T,Kiriyama S,Tanikawa M,Hisanaga Y,Kanamori A,Niinomi T,Yasuda S,Andou Y,Yamamoto K,Tanaka J
    BACKGROUND & AIMS: BACKGROUND & AIMS:Some patients with chronic hepatitis B virus (HBV) infection progress to hepatocellular carcinoma (HCC). However, the long-term effect of nucleos(t)ide analogue (NA) therapy on progression to HCC is unclear. METHODS:Therefore, we compared chronic hepatitis B patients who received NA therapy to those who did not, using a propensity analysis. RESULTS:Of 785 consecutive HBV carriers between 1998 and 2008, 117 patients who received NA therapy and 117 patients who did not, were selected by eligibility criteria and propensity score matching. Factors associated with the development of HCC were analyzed. In the follow-up period, HCC developed in 57 of 234 patients (24.4%). Factors significantly associated with the incidence of HCC, as determined by Cox proportional hazards models, include higher age (hazard ratio, 4.36 [95% confidence interval, 1.33-14.29], p=0.015), NA treatment (0.28 [0.13-0.62], p=0.002), basal core promoter (BCP) mutations (12.74 [1.74-93.11], p=0.012), high HBV core-related antigen (HBcrAg) (2.77 [1.07-7.17], p=0.036), and high gamma glutamyl transpeptidase levels (2.76 [1.49-5.12], p=0.001). CONCLUSIONS:NA therapy reduced the risk of HCC compared with untreated controls. Higher serum levels of HBcrAg and BCP mutations are associated with progression to HCC, independent of NA therapy.
    背景与目标: 背景与目的:某些慢性乙型肝炎病毒(HBV)感染患者会发展为肝细胞癌(HCC)。然而,尚不清楚核苷酸(t)ide类似物(NA)治疗对肝癌进展的长期影响。
    方法:因此,我们使用倾向分析将接受NA治疗的慢性乙型肝炎患者与未接受NA治疗的慢性乙型肝炎患者进行比较。
    结果:在1998年至2008年之间的785例连续HBV携带者中,通过资格标准和倾向评分匹配选择了接受NA治疗的117例患者和未接受NA治疗的117例患者。分析了与肝癌发展相关的因素。在随访期间,234例患者中有57例发生了HCC(24.4%)。由Cox比例风险模型确定的与HCC发生率显着相关的因素包括较高的年龄(风险比,4.36 [95%置信区间,1.33-14.29],p = 0.015),NA治疗(0.28 [0.13-0.62]) ,p = 0.002),基础核心启动子(BCP)突变(12.74 [1.74-93.11],p = 0.012),高HBV核心相关抗原(HBcrAg)(2.77 [1.07-7.17],p = 0.036)和高γ-谷氨酰转肽酶水平(2.76 [1.49-5.12],p = 0.001)。
    结论:与未治疗的对照组相比,NA治疗降低了HCC的风险。血清HBcrAg和BCP突变的较高水平与肝癌进展相关,而与NA治疗无关。
  • 【乳制品和非乳制品中的钙对亚位大肠癌风险的影响。】 复制标题 收藏 收藏
    DOI:10.1007/BF02134177 复制DOI
    作者列表:Stemmermann GN,Nomura A,Chyou PH
    BACKGROUND & AIMS: :This prospective study assesses the impact of fat and calcium intake on the risk of developing cancer in each large-bowel subsite. The study population is a cohort of Hawaii Japanese men who experience high rates of colon cancer, especially of the sigmoid segment. Total calcium intake is not related to the risk of colon cancer, and separation of calcium into dairy and nondairy sources does not alter the result. There is, however, a significant, monotonic increase in sigmoid colon cancer risk with decreasing total calcium intake. Similar trends are shown for both dairy and nondairy calcium. Dietary calcium is not consumed in large quantities among the Hawaii Japanese, partly because of their limited consumption of milk due to lactose intolerance. If calcium plays a protective role against sigmoid colon cancer, this effect is unlikely to be related to fat intake. Sigmoid colon cancer subjects had lower intakes of fat than other cohort men, and a statistical test for the interaction effect of total calcium and fat intake on colon cancer risk was statistically insignificant (P = 0.2).
    背景与目标: :这项前瞻性研究评估了每个大肠亚部位中脂肪和钙的摄入对罹患癌症风险的影响。该研究人群是夏威夷日本男性的队列,他们的结肠癌特别是乙状结肠癌的发生率很高。钙的总摄入量与结肠癌的风险无关,将钙分为乳品和非乳品来源也不会改变结果。但是,随着总钙摄入量的减少,乙状结肠癌的风险显着单调增加。乳品钙和非乳品钙也显示出相似的趋势。在夏威夷日本人中,饮食中的钙摄入量不大,部分原因是由于乳糖不耐症,牛奶摄入量有限。如果钙对乙状结肠癌起保护作用,则这种作用不太可能与脂肪摄入有关。乙状结肠癌受试者的脂肪摄入量低于其他队列男性,并且总钙和脂肪摄入对结肠癌风险的相互作用的统计学检验在统计学上无统计学意义(P = 0.2)。
  • 【降低ST段抬高型心肌梗死的手术围手术期死亡率和of骨入路出血率。倾向得分分析来自ORPKI波兰国家注册局的数据。】 复制标题 收藏 收藏
    DOI:10.4244/EIJ-D-17-00078 复制DOI
    作者列表:Siudak Z,Tokarek T,Dziewierz A,Wysocki T,Wiktorowicz A,Legutko J,Żmudka K,Dudek D
    BACKGROUND & AIMS: AIMS:We sought to evaluate bleeding complications and periprocedural outcomes of the radial approach (RA) as compared to the femoral approach (FA) during percutaneous coronary intervention (PCI) in "real-world" patients with ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS:The study group consisted of 22,812 consecutive patients with STEMI treated with PCI and stent implantation between January 2014 and June 2015 in 151 tertiary invasive cardiology centres in Poland (the ORPKI Polish National Registry). Patients treated using the RA and FA were compared using a propensity score analysis to avoid possible selection bias. The analysis was carried out in an "as-treated" manner. The FA was used in 9,334 (40.9%) and the RA in 13,478 (59.1%) patients. After propensity score matching, a higher total amount of contrast (191.8±8.0 vs. 174.8±68.8 ml; p=0.001) and lower radiation doses (1,279.5±1,346.3 vs. 1,182.6±887 mGy; p=0.02) were reported in FA. More access-site-related bleeding complications after both angiography (0.17% vs. 0.02%; p=0.004) and PCI (0.23% vs. 0.09%; p=0.049) were reported in the FA group. Periprocedural death (1.94% vs. 0.93%; p=0.001) was more common after PCI performed with the FA. CONCLUSIONS:The radial approach was associated with a lower incidence of periprocedural death in STEMI patients as well as a significant reduction of bleeding complications at the access site.
    背景与目标: 目的:我们试图评估“现实” ST段抬高型心肌梗死(STEMI)患者在经皮冠状动脉介入治疗(PCI)期间与股动脉入路(FA)相比,radial动脉入路(RA)的出血并发症和围手术期结局)。
    方法与结果:该研究小组于2014年1月至2015年6月在波兰的151个三级侵入性心脏病学中心(ORPKI波兰国家注册中心)对22,812例连续的STEMI患者进行了PCI和支架植入治疗。使用倾向评分分析比较使用RA和FA治疗的患者,以避免可能的选择偏倚。该分析以“处理后”的方式进行。 FA用于9,334(40.9%),RA用于13,478(59.1%)患者。倾向得分匹配后,FA中的造影剂总量较高(191.8±8.0 vs. 174.8±68.8 ml; p = 0.001)和较低的放射剂量(1,279.5±1,346.3 vs.1,182.6±887 mGy; p = 0.02)。在FA组中,血管造影后(0.17%vs. 0.02%; p = 0.004)和PCI(0.23%vs. 0.09%; p = 0.049)出现更多的与出入部位相关的出血并发症。在FA进行PCI后,围手术期死亡(1.94%vs. 0.93%; p = 0.001)更为常见。
    结论:radial动脉入路与STEMI患者围手术期死亡的发生率较低,以及进入部位出血并发症的发生率显着降低有关。
  • 【异纤毛纤毛虫日本血吸虫中肌层网络的超微结构和钙依赖性收缩。】 复制标题 收藏 收藏
    DOI:10.1016/S0932-4739(11)80234-8 复制DOI
    作者列表:Ishida M,Suzaki T,Shigenaka Y,Sugiyama M
    BACKGROUND & AIMS: :This laboratory has previously demonstrated that shortening of the cell body of a heterotrich ciliate, Blepharisma japonicum, could be induced as a step-down photophobic response. Here, we examined the structure and contractility of the myonemes in detergent-extracted cell models and in isolated cortical fragments. Ultrastructural observation showed that the myoneme was connected to the basal ends of the posterior kinetosomes and constructed a systematic network as a whole. Shortening of the cell model was induced by > 10(-4) M Ca(2+), while the rounded cell model did not re-elongate even when it was washed in a calcium-free solution either with or without addition of ATP. Fluffy fibrils, which were tentatively identified as aggregated bundles of the myonemes, were isolated with the kinetosomal complex and showed calcium-dependent and ATP-independent contraction. The minimum concentration of Ca(2+) required for inducing contraction was at the level of 10(-6) M. These results suggest that the cell body shortening in Blepharisma is caused by the Ca(2+)-dependent contraction of the myonemal network.
    背景与目标: :该实验室先前已证明杂多纤毛纤毛虫(Blepharisma japonicum)的细胞体缩短可以作为逐步降低的憎光反应而被诱导。在这里,我们检查了去污剂提取的细胞模型和分离的皮层碎片中的模因的结构和收缩性。超微结构观察表明,肌球蛋白与后运动体的基端相连,并构成了一个整体的系统网络。细胞模型的缩短是由> 10(-4)M Ca(2)引起的,而圆形细胞模型即使在无钙溶液中添加或不添加ATP洗涤也不会重新伸长。蓬松的原纤维被初步确定为肌源蛋白的聚集束,与运动体复合物分离并显示出钙依赖性和ATP依赖性收缩。诱导收缩所需的Ca(2)的最低浓度为10(-6)M。这些结果表明,血吸虫病中的细胞体缩短是由肌层网络的Ca(2)依赖性收缩引起的。
  • 【成功的导管消融可降低CHA2DS2-VASc风险评分为1或更高的房颤患者发生心血管事件的风险。】 复制标题 收藏 收藏
    DOI:10.1093/europace/eus336 复制DOI
    作者列表:Lin YJ,Chao TF,Tsao HM,Chang SL,Lo LW,Chiang CE,Hu YF,Hsu PF,Chuang SY,Li CH,Chung FP,Chen YY,Wu TJ,Hsieh MH,Chen SA
    BACKGROUND & AIMS: AIMS:It is not known if successful catheter ablation for atrial fibrillation (AF) improves the patient's long-term cardiovascular outcomes. This study investigated the long-term outcomes and mortality of AF patients at high risk who received antiarrhythmic medication and catheter ablation. METHODS AND RESULTS:The propensity scores for AF were calculated for each patient and were used to assemble a cohort of 174 AF patients with ablation who were compared with an equal number of AF patients without ablation. Composite cardiovascular end points (major adverse cardiovascular event, MACE), including mortality and vascular events in the medically treated patients representing the control group (group 1), were compared with those in the ablation-treated patients (group 2). The rates of the total mortality (2.95% vs. 0.74% per year; P < 0.01), cardiovascular death (1.77% vs. 0% per year; P = 0.001), and ischaemic stroke/transient ischaemic attack (2.21% vs. 0.59% per year; P = 0.02) were higher in group 1 than group 2, respectively. A multivariate Cox regression analysis of the MACE scores showed that a higher CHA2DS2-VASc score [hazard ratio (HR) = 1.309 per increment of score, 95% confidence interval (CI) = 1.06-1.617; P = 0.01] and the performance of the ablation procedure (HR = 0.225, CI = 0.076-0.671; P = 0.007) were independent predictors of a MACE. In patients who received catheter ablation, recurrence of any atrial arrhythmia was a predictor of vascular events and total mortality (P < 0.05). CONCLUSION:In AF patients with CHA2DS2-VASc score ≥1, catheter ablation of AF reduced the risk of the total/cardiovascular mortality and total vascular events. Atrial fibrillation recurrence predicts long-term cardiovascular outcomes, as well as the CHA2DS2-VASc score.
    背景与目标: 目的:尚不清楚成功的心房纤颤(AF)导管消融术能否改善患者的长期心血管结局。这项研究调查了接受抗心律不齐药物和导管消融治疗的高危房颤患者的长期预后和死亡率。
    方法和结果:计算每位患者的房颤倾向评分,并用其汇总了174例房颤消融的房颤患者,与无消融的房颤患者进行比较。将复合心血管终点(主要不良心血管事件,MACE),包括代表对照组(第1组)的药物治疗患者的死亡率和血管事件,与消融治疗患者(第2组)进行了比较。总死亡率(每年2.95%比0.74%; P <0.01),心血管死亡(每年1.77%比0%; P = 0.001)和缺血性中风/短暂性脑缺血发作的发生率(2.21%比2%)。每年0.59%; P = 0.02)在第1组中分别高于第2组。 MACE分数的多变量Cox回归分析显示,CHA2DS2-VASc分数较高[危险比(HR)= 1.309 /分数递增,95%置信区间(CI)= 1.06-1.617; P = 0.01]和消融程序的执行情况(HR = 0.225,CI = 0.076-0.671; P = 0.007)是MACE的独立预测因子。在接受导管消融的患者中,任何心律失常的复发都是血管事件和总死亡率的预测指标(P <0.05)。
    结论:在CHA2DS2-VASc评分≥1的房颤患者中,导管消融房颤可降低总/心血管死亡和总血管事件的风险。心房颤动的复发可预测长期的心血管结局,以及CHA2DS2-VASc评分。
  • 【钙介导的嘌呤能刺激和钙离子敏感的腺苷酸环化酶同工型在人气道上皮细胞中的极化定位。】 复制标题 收藏 收藏
    DOI:10.1016/j.febslet.2007.06.015 复制DOI
    作者列表:Nlend MC,Schmid A,Sutto Z,Ransford GA,Conner GE,Fregien N,Salathe M
    BACKGROUND & AIMS: :Purinergic stimulation of human airway epithelia results in a prolonged increase in ciliary beat frequency that depends on calcium-mediated cAMP production [Lieb, T., Wijkstrom Frei, C., Frohock, J.I., Bookman, R.J. and Salathe, M. (2002) Prolonged increase in ciliary beat frequency after short-term purinergic stimulation in human airway epithelial cells. J. Physiol. (Lond.) 538, 633-646]. Here, fully differentiated human airway epithelial cells in culture are shown to express calcium-stimulated transmembrane adenylyl cyclase (tmAC) isoforms (types 1, 3, and 8) by reverse transcription polymerase chain reaction. Immunohistochemistry of tracheal sections and fully differentiated airway epithelial cell cultures revealed polarized expression of these tmACs, with types 1 and 8 localized to the apical membrane and thus at the position required for ciliary regulation. Real-time, ciliated-cell specific cAMP production by tmACs upon apical, purinergic stimulation with UTP was confirmed using fluorescent energy resonance transfer between fluorescently tagged PKA subunits.
    背景与目标: :对人气道上皮的脓毒症刺激导致纤毛搏动频率的延长增加,这取决于钙介导的cAMP的产生[Lieb,T.,Wijkstrom Frei,C.,Frohock,J.I.,Bookman,R.J.和Salathe,M.(2002)短期嘌呤能刺激人气道上皮细胞后,纤毛搏动频率延长。 J.生理学。 (Lond。)538,633-646]。在这里,在培养物中完全分化的人气道上皮细胞显示出通过逆转录聚合酶链反应表达钙刺激的跨膜腺苷酸环化酶(tmAC)同工型(1、3和8型)。气管切片和完全分化的气道上皮细胞培养物的免疫组织化学揭示了这些tmAC的极化表达,其中1型和8型位于心尖膜,因此位于睫状调节所需的位置。使用荧光标记的PKA亚基之间的荧光能量共振转移,可以确认tmAC在使用UTP进行根尖,嘌呤能刺激后实时产生纤毛细胞,并产生特定的cAMP。
  • 【肾性肾病的钙触发的萤光素结合蛋白的表达,纯化和鉴定。】 复制标题 收藏 收藏
    DOI:10.1016/j.pep.2006.07.028 复制DOI
    作者列表:Inouye S
    BACKGROUND & AIMS: :The Ca2+-triggered luciferin-binding protein of Renilla reniformis (RLBP) is a non-covalent complex of apoprotein (apoRLBP) and coelenterazine (luciferin). The gene encoding apoRLBP with 552 nucleotides has been synthesized by assembly PCR methods with synthetic oligonucleotides, and the histidine-tagged apoRLBP expressed as a soluble form in the periplasmic space of Escherichia coli cells. The apoRLBP was purified by nickel chelate chromatography and the procedure yielded 18.2mg of recombinant apoRLBP from 80 ml of cultured cells with purity greater than 95%. The purified apoRLBP was converted to RLBP by incubation with coelenterazine in the presence of dithiothreitol and the purity of recombinant RLBP was estimated to be over 95% by comparison with the absorption spectral data of native RLBP. When RLBP mixed with Ca2+, coelenterazine was dissociated from RLBP and was utilized for the luminescence reaction of Renilla luciferase. Also semi-synthetic RLBPs with h-, e-, and Bis-coelenterazines were prepared and characterized.
    背景与目标: 肾性肾病(RLBP)的Ca2触发的萤光素结合蛋白是载脂蛋白(apoRLBP)和腔肠素(萤光素)的非共价复合物。已经用合成的寡核苷酸通过组装PCR方法合成了具有552个核苷酸的编码apoRLBP的基因,并且组氨酸标记的apoRLBP在大肠杆菌细胞的周质空间中以可溶形式表达。通过镍螯合层析纯化apoRLBP,该程序从80ml培养的细胞中产生18.2mg重组apoRLBP,纯度大于95%。通过在二硫苏糖醇存在下与腔肠素一起孵育,将纯化的apoRLBP转化为RLBP,与天然RLBP的吸收光谱数据相比,重组RLBP的纯度估计超过95%。当RLBP与Ca2混合时,腔肠素与RLBP分离,并用于海肾荧光素酶的发光反应。还制备并表征了具有h-,e-和Bis-腔肠素的半合成RLBP。
  • 【原发性高血压的肾脏保护:血管紧张素转换酶抑制剂与钙拮抗剂相比如何?】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Bauer JH,Reams GP
    BACKGROUND & AIMS: :By interrupting the integrity of the systemic and renal renin-angiotensin system, angiotensin-converting enzyme inhibitors have been shown, experimentally, to preferentially reduce postglomerular capillary arteriolar resistance, to reduce glomerular capillary pressure, and to increase the ultrafiltration coefficient. Under normal physiological conditions, angiotensin-converting enzyme inhibitors have little effect on glomerular filtration rate; however, they increase effective renal plasma flow at renal perfusion pressures within the normal autoregulatory range and renal vascular resistance is decreased. In contrast, calcium antagonists have been shown, experimentally, to preferentially reduce preglomerular capillary arteriolar resistance. Their effects on angiotensin II and postglomerular capillary arteriolar resistance (hence, glomerular capillary pressure and the ultrafiltration coefficient) are controversial. Under normal physiological conditions, calcium antagonists increase both glomerular filtration rate and effective renal plasma flow at renal perfusion pressures within the normal autoregulatory range and renal vascular resistance is decreased. In patients with essential hypertension, studies have demonstrated that angiotensin-converting enzyme inhibitors (as predicted) sustain glomerular filtration rate, increase effective renal plasma flow, and decrease renal vascular resistance. However, essential hypertensive patients with impaired glomerular filtration rate may demonstrate marked improvement in both glomerular filtration rate and effective renal plasma flow. Calcium antagonists (as predicted) may increase both glomerular filtration rate and effective renal plasma flow (at high renal perfusion pressures) and may decrease renal vascular resistance. Calcium antagonists may also improve both glomerular filtration rate and effective renal plasma flow in patients with impaired glomerular filtration rate. Long-term clinical trials comparing the renal effects of angiotensin-converting enzyme inhibitors with those of calcium antagonists in essential hypertensive patients have not been reported. It remains to be determined if the potentially different effects of these two classes of antihypertensive drugs on the renal microcirculation do or do not translate into different renal protective advantages to patients at risk for the development and/or progression of hypertensive nephrosclerosis.
    背景与目标: 通过实验证明,通过破坏全身和肾脏的肾素-血管紧张素系统的完整性,血管紧张素转化酶抑制剂可优先降低肾小球毛细血管小动脉阻力,降低肾小球毛细血管压力,并增加超滤系数。在正常的生理条件下,血管紧张素转化酶抑制剂对肾小球滤过率的影响很小。但是,它们在正常自我调节范围内的肾脏灌注压力下会增加有效的肾脏血浆流量,并且肾血管阻力降低。相反,实验表明钙拮抗剂可优先降低肾小球前毛细血管的阻力。它们对血管紧张素II和肾小球后毛细血管小动脉阻力(因此,肾小球毛细血管压力和超滤系数)的影响是有争议的。在正常生理条件下,钙拮抗剂在正常自动调节范围内的肾脏灌注压力下会增加肾小球滤过率和有效肾血浆流量,并且肾血管阻力降低。在原发性高血压患者中,研究表明,血管紧张素转化酶抑制剂(如预期的那样)可维持肾小球滤过率,增加有效肾血浆流量并降低肾血管阻力。然而,肾小球滤过率受损的原发性高血压患者可能表现出肾小球滤过率和有效肾血浆流量的明显改善。钙拮抗剂(如预期的那样)可能会增加肾小球滤过率和有效的肾血浆流量(在高肾灌注压力下),并且可能会降低肾血管阻力。对于肾小球滤过率受损的患者,钙拮抗剂还可以改善肾小球滤过率和有效的肾血浆流量。尚未有长期临床试验比较血管紧张素转化酶抑制剂与钙拮抗剂在基本高血压患者中的肾脏作用。这两类降压药对肾脏微循环的潜在不同作用是否会转化为对患有高血压肾硬化发展和/或进展风险的患者的不同肾脏保护优势,尚待确定。
  • 【垂体促性腺激素中一种新型的钙激活的对罂粟碱不敏感的钾电流。】 复制标题 收藏 收藏
    DOI:10.1210/endo.138.7.5220 复制DOI
    作者列表:Vergara L,Rojas E,Stojilkovic SS
    BACKGROUND & AIMS: In cultured rat pituitary gonadotrophs, GnRH-induced oscillations in cytosolic calcium concentration ([Ca2+]i) are associated with periodic membrane hyperpolarization. The hyperpolarizing waves are secondary to the activation of apamin-sensitive Ca2+-activated K+ channels that account for a single class of 125I-apamin binding sites present in these cells. In a substantial fraction of gonadotrophs, however, we observed a Ca2+-controlled oscillatory current that was resistant to apamin, even at concentrations five orders of magnitude higher than the dissociation constant (Kd) observed in the binding experiments. With the K+ in the pipette, the apamin-resistant current showed a reversal potential of -42 mV, nearly 40 mV more positive than that of the apamin-sensitive current. With Cs+ in place of K+ in the pipette solution, both the size of the apamin-insensitive current and its reversal potential remained unchanged. Ion substitution studies further revealed that the reversal potential was independent of Cl-. In contrast, an 11 mV hyperpolarizing shift in the reversal potential occurred when extracellular Na+ was reduced to 80 mM. In cells expressing apamin-resistant conductances, addition of apamin evoked a marked increase in the duration of the action potentials and reduction in the frequency of spontaneous spiking. In the presence of GnRH, gonadotrophs exhibit the typical burst pattern of electrical activity. Further exposure of the cells to apamin depolarized the membrane from a silent phase bursting level of about -80 mV to a new level of about -40 mV. These observations indicate that, in addition to apamin-sensitive current, a subpopulation of pituitary gonadotrophs also expresses a cationic component of the Ca2+-activated membrane conductance that has the potential to remodulate spontaneous and agonist-induced electrical activity.

    背景与目标: 在培养的大鼠垂体促性腺激素中,GnRH诱导的胞浆钙浓度([Ca2] i)振荡与周期性膜超极化有关。超极化波是对罂粟碱敏感的Ca2激活的K通道的激活的继发子,这些通道解释了这些细胞中存在的一类125I-apapamin结合位点。然而,在相当一部分的促性腺激素中,即使在比结合实验中观察到的解离常数(Kd)高5个数量级的浓度下,我们也观察到了对apamin有抗性的Ca2控制的振荡电流。当移液器中的K值时,抗木瓜蛋白酶的电流显示出-42 mV的反向电位,比对木瓜蛋白酶敏感的电流的正电位高近40 mV。在移液器中用Cs代替K时,对罂粟碱不敏感电流的大小及其逆转电位均保持不变。离子取代研究进一步表明,逆转电位独立于Cl-。相反,当细胞外Na降至80 mM时,逆转电位发生11 mV超极化变化。在表达抗谷氨酰胺的电导的细胞中,添加谷氨酰胺可引起动作电位持续时间的显着增加和自发加标频率的降低。在存在GnRH的情况下,促性腺激素表现出典型的电活动猝发模式。将细胞进一步暴露于罂粟碱可使膜从约-80 mV的无声相爆发水平去极化至约-40 mV的新水平。这些观察结果表明,除了对罂粟碱敏感的电流外,垂体促性腺激素亚群还表达了Ca2激活的膜电导的阳离子成分,该成分可能会重新调节自发和激动剂诱导的电活动。

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