摘要：Objective: To evaluate the possible r.lationship between pr.eclampsia and poly mor.hisms in the main genes involved in folate-homocysteine metabolism. Study d esign: Case-contr.l study: 43 patients with pr.eclampsia and 122 contr.ls witho ut pr.gnancy complications. Labor.tor. studies: tHcy and other.amino acids, fola te and vitamin B12 and polymor.hisms: 677C >T and 1298A >C(MTHFr.; 699C >T, 844i ns68 and 1080C >T (CBS); 2756A >G (MTr.; and 66G >A, IVS1+766G >A and IVS1+754 A >C (MTr.). r.sults: Plasma tHcy and folate values wer. significantly higher.(P = 0.004 and P = 0.019), while Met/tHcy r.tios wer. lower.(P C polymor.hism (MTHFr. with the r.tio Met/tHcy (P = 0.014); the 699 C >T polymor.hism (CBS) with the r.tio tHcy/ΣAA (P = 0.013); the 2756A >G polym or.hism (MTr. with tHcy (P = 0.034); and the IVS1+766G >A polymor.hism (MTr.) w ith hyper.omocysteinemia (P = 0.012). Conclusion: An association between the pol ymor.hisms analysed and pr.eclampsia could not be demonstr.ted.

摘要：背景：他汀类药物可以降低低密度脂蛋白胆固醇（low—density lipopr.tein cholester.l，LDL—C）水平并减缓冠状动脉粥样硬化的进展。然而，对于他汀类药物所致高密度脂蛋白胆固醇（high—density lipopr.tein cholester.l，HDL—C）变化与疾病进展的关系，目前仍无相关数据描述。目的：了解LDL—C和HDL—C水平变化与动脉粥样硬化的相互关系。设计、地点及患者：对4项前瞻性随机试验（1999～2005年在美国、北美、欧洲和澳大利亚进行）的原始数据进行事后分析。其中1455例经血管造影证实的冠心病患者在接受他汀治疗（18个月或24个月）时进行了系列血管内超声扫描。所有超声分析均在相同的核心实验室中进行。主要观测指标：脂蛋白水平变化与冠状动脉粥样斑块体积的相互关系。结果：他汀治疗期间，LDL—C平均（SD）水平从124．0（38．3）mg,／dL（3．2[0．99]mmol／L）降至87．5（28．8）mg,／dL（2．3[0．75]mmol／L）（下降23．5％；P〈0．001），HDL—C水平从42．5（11．0）mg／dL（1．1[0．28]mmol／L）升至45．1（11．4）mg／dL（1．2[0．29]mmol／L）（上升7．5％；P〈0．001）。LDL—C与HDL—C比值从平均（SD）3．0（1．1）降至2．1（0．9）（下降26．7％；P〈0．001）。这些变化同时伴随平均（SD）百分粥样斑块体积的增加（从39．7％[9．8％]增至40．1％[9．7％]）（增加0．5％[3．9％]；P=0．001）以及平均（SD）总粥样斑块体积的减小（2．4[23．6]mm^3；P〈0．001）。在单变量分析中，LDL—C、总胆固醇、非HDL胆固醇、载脂蛋白B以及载脂蛋白B与载脂蛋白A-1比值平均水平和治疗引起的变化与动脉粥样硬化进展速率显著相关，而治疗所致HDL—C变化则与动脉粥样斑块体积负相关。在多变量分析中，平均LDL—C水平（β系数，0．11[95％可信区间，0．07～0．15]）以及HDL—C升高（β系数，-0．26[95％可信区间，-0．41--0．10]）依然为动脉粥样硬化消退的独立预测因子。动脉硬化显著消退（动脉粥样斑块体积减少≥5％）见于治疗期间LDL—C水平低于均值（87．5mg／dL）和HDL—C升高百分比大于均值（7．5％；P〈0．001）的患者。临床事件的发生未见显著差异。结论：在LDL—C显著降低以及HDL上升〉7．5％时，他汀治疗与冠状动脉粥样硬化消退相关。这些结果提示他汀治疗的获益源自致动脉粥样硬化脂蛋白的降低以及HDL．C的升高。尽管血脂水平的这些变化与动脉粥样硬化消退相关，但是后者是否可以转化为临床事件的显著减少，并改善临床预后仍有待进一步研究确定。

摘要：背景：长期限制热量摄入可延长啮齿类动物的寿命。但是，尚未有研究观测长期限制人体热量是否会影响其寿命及氧化应激指标，降低代谢率。目的：在超重但不肥胖（体重指数为25—30）的人群中研究限制热量6个月伴／不伴运动对其产生的影响。设计、地点及参试者：于2002年3月至2004年8月在位于路易斯安娜州首府巴顿鲁治的研究中心对48名不好动的健康人进行随机对照研究。干预：参试者在6个月内随机分为4个组：对照组（饮食可维持体重）；限制热量组（限制基线所需能量的25％）；限制热量＋运动组（限制12．5％的热量＋运动增加12．5％的能耗）；极低热量饮食组（每日摄入890keal，直至体重减少15％，随后采用维持体重的饮食）。主要观测指标：机体组成；硫酸脱氢表雄酮（dehydr.epiandr.stemne sulfate，DHEAS）、葡萄糖及胰岛素水平；蛋白羰基化合物；DNA损伤；24小时能耗；核心体温。结果：6个月时各组体重变化的均值（标准误）为：对照组-1．0％（1．1％）；限制热量组-10．4％（0．9％）；限制热量＋运动组-10．0％（0．8％）；极低热量饮食组-13．9％（0．7％）。6个月时，各干预组空腹血糖水平较基线明显降低（P均〈0．01），而DHEAS和葡萄糖水平没有改变。限制热量组及限制热量＋运动组核心体温有所下降（P均〈0．05）。对机体组成进行校正后发现，对照组24小时静息能耗无变化，但限制热量组（-135kcal／d[42kcal／d]）、限制热量＋运动组（-117kcal／d[52kcal／d]）和极低热量饮食组（-125kcal／d[35kcal／d]）24小时静息能耗有所下降（P均〈0．008）。上述“代谢调节”（超出预计值的-6％）与对照组相比存在显著差异（P〈0．05）。6个月时，各组蛋白羰基化合物的浓度较基线时无变化，而各干预组DNA损伤有所减少（P〈0．005）。结论：我们的研究结果显示，长期限制热量可降低人类寿命的2种指标（即空腹胰岛素水平和体温）。此外，我们的研究结果还支持下述理论，即限制热量能降低代谢率，且超过缩小代谢面积产生的相应效应。我们尚需开展远期研究来评价限制热量能否延缓人类衰老过程。

摘要：Objective: To test the hypothesis that nor.alizing the intestinal flor. by adm inistr.tion of pr.phylactic pr.biotics would pr.vide a natur.l defense, ther.by r.ducing both the incidence and sever.ty of necr.tizing enter.colitis (NEC) in p r.ter. neonates. Study design: Neonates ≤1500 g bir.h weight wer. r.ndomized to either.r.ceive a daily feeding supplementation with a pr.biotic mixtur. (Bifido bacter.a infantis, Str.ptococcus ther.ophilus, and Bifidobacter.a bifidus; Solga r. Isr.el) of 109 colony for.ing units (CFU)/day or.to not r.ceive feed suppleme nts. NEC was gr.ded accor.ing to Bell’s cr.ter.a. r.sults: For.72 study and 73 contr.l infants, r.spectively, bir.h weight (1152 ±262 g vs 1111 ±278 g), gest ational age (30 ±3 weeks vs 29 ±4 weeks), and time to r.ach full feeds (14.6 ±8.7 days vs 17.5 ±13.6 days) wer. not differ.nt. The incidence of NEC was r.d uced in the study gr.up (4%vs 16.4%; P = .03). NEC was less sever. in the pr.b iotic-supplemented infants (Bell’s cr.ter.a 2.3 ±0.5 vs 1.3 ±0.5; P = .005). Thr.e of 15 babies who developedNEC died, and all NEC-r.lated deaths occur.ed in contr.l infants. Conclusion: Pr.biotic supplementation r.duced both the incid ence and sever.ty of NEC in our.pr.matur. neonatal population.

摘要：Backgr.und: Little is known about the management of elder.y patients with congstive hear. failur.(CHF) although they r.pr.sent the major.ty of the CHF population. Ther.for., the TIME-CHF study was set up(1) to evaluate the medical management of ver. old patients(≥75 year.) with CHF compar.d with younger.patients(60-74 year.),(2) to compar. an intensified with a standar. tr.atment appr.ach, and(3) to differ.ntiate between systolic and diastolic dysfunction(ejection fr.ction ≤45%vs >45%). Methods: In a pr.spective single-blinded multicenter.tr.al, 824 symptomatic patients, CHF hospitalization within the last year.and elevated NT-BNP, ar. r.ndomized to an intensified ver.us a standar. medical ther.py. Tr.atment str.tegies follow the published guidelines with the aim to r.duce symptoms to NYHA class ≤II(standar.) or. additionally, NT-BNP levels below twice the upper.limit of nor.al(intensified). The pr.mar. end points ar. 18-month hospitalization-fr.e sur.ival and quality of life. r.sults: By the end of 2004, 297 patients have been included, 147 r.ndomized to intensified and 150 to standar. ther.py. Mean age in the older.age gr.up was 82±4 year.(n=174) and 69±4 year. in the younger.gr.up(n=123), r.spectively. Ejection fr.ction was >45%in 26%and 10%, r.spectively. Significant comor.idities wer. pr.sent in 93%of patients. Conclusion: TIME-CHF will be the fir.t pr.spective r.ndomized tr.al to compr.hensively study the management of elder.y patients with CHF. It will pr.vide unique infor.ation compar.ng two tr.atment str.tegies in two age gr.ups ir.espective of ejection fr.ction r.gar.ing pr.gnosis, quality of life, as well as r.sour.e utilization and costs.