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Kallistatin, which protects organs and cells against inflammation, fibrosis and oxidative stress, is mainly synthesized and secreted in liver. However, its relationship to human liver disease remains unclear. The purpose of this study was to explore the relationship between serum kallistatin and clinical evidence of both cirrhosis and hepatocellular carcinoma (HCC), and to determine if serum kallistatin levels could be used as a diagnostic indicator of hepatic health status, especially human liver cirrhosis (LC). Our cohort consisted of 115 patients with clinically proven liver fibrosis (LF), LC, or HCC by liver biopsies, and 31 healthy controls (CON). Serum kallistatin levels were quantified by ELISA. Results of the present study demonstrated that irrespective of the underlying etiology, serum kallistatin levels were significantly lower in the LF/LC group when compared with the CON group. A decrease in serum kallistatin levels appeared to reflect the extent of cirrhosis, with the lowest levels associated with higher grades of cirrhosis. Patients with LC had a noticeable correlation between serum kallistatin levels and other serum biochemical indicators. The area under the curve (AUC) for LC, viral liver cirrhosis (VLC) and alcoholic liver cirrhosis (ALC) was 0.845, 0.757 and 0.931, respectively. In conclusion, our findings demonstrated that kallistatin, a plasma protein produced by the liver, can be a useful and reliable diagnostic indicator of hepatic health status, especially for LC.
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Objective To investigate the relationship between H-type hypertension and unstable angina (UA).Methods Totally 147 elderly inpatients with hypertension and angina in our hospital were selected.Patients were divided into H-type hypertension group [n=72,serum homocysteine (Hcy) level ≥10 μmol/L] and primary hypertension group [n=75,serum homocysteine (Hcy) level ＜10 μmol/L].All patients underwent coronary angiography.Serum Hcy level was measured by enzyme method and compared between groups.Results There were statistical differences in the UA incidence,Gensini's score and high sensitive C-reactive protein (hsCRP) level between the H-type hypertension group and primary hypertension group [(44.4％ (32/72) vs.12.0％ (9/75),(44.2± 21.3) vs.(31.9±18.4),(4.3±2.1) μg/L vs.(2.0±1.9) μg/L,respectively,all P＜0.01].Serum Hcy level in H-type hypertension group was higher during UA attack than during UA remission [(22.2±7.1)μmol/L vs.(13.7±3.7)μmol/L,P＜ 0.01].Serum Hcy level during UA attack was increased in H-type hypertension group than in stable angina group [(22.2±7.1)μmol/L vs.(12.0± 4.2) μmol/L,P ＜ 0.01].Serum levels of Hcy,total cholesterol and low density lipoprotein cholesterol in primary hypertension group were higher in UA patients than in stable angina patients [(8.9±2.2)μmol/L vs.(6.6± 1.2)μmol/L,(6.9±0.7)mmol/L vs.(4.5±0.5)mmol/L,(4.6±0.8)mmol/L vs.(2.7 ± 0.6) mmol/L,respectively,P＜ 0.01 or P＜0.05].Logistic regression analysis showed that H-type hypertension was the independent risk factor for unstable angina in the elderly (OR =5.691,P ＜ 0.01).Conclusions H-type hypertension is closely correlated with unstable angina,which is the independent risk factor for unstable angina in the elderly.Serum Hcy level has significant correlation with coronary atherosclerotic plaque stability and the severity of coronary artery disease.
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Objective To evaluate the feasibility of community treatment and management mode in elderly patients with hypertension.Methods A total of 286 elderly patients with hypertension were treated with community therapy and management for 6 months.The improvements in life style and hypertension control were observed before and after the community treatment and management.Results There were significant differences in systolic blood pressure and diastolic blood pressure in the elderly patients before and after the treatment and management [(158.4± 11.3) mm Hg vs.(131.3±5.9) mm Hg,(99.6±8.9) mm Hg vs.(81.5±5.6) mm Hg,respectively,both P＜0.05].Compared with pretreatment,the blood pressure control rate,the awareness rate of diagnostic criteria and the drug compliance were significantly increased after the treatment and management [38.5％ (110/286) vs.96.9％ (277/286),66.4％ (190/286) vs.100％ (286/286),49％ (140/286)vs.91.3％ (261/286),x2 =98.87,115.36,122.13,respectively,all P＜0.01].Conclusions The community treatment and management can increase the blood pressure control rate and improve the quality of life in elderly patients with hypertension.It is a feasible method to comprehensively prevent and control hypertension.
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Human gene therapy needs to express exogenous DNA at the targeting cells,producing a practical and efficient therapeutic dosage at an approp-riate time(quantitative pharmacology)with a safe man-ner.Recombinant adeno-associated virus(rAAV)Vec-tom possess a number of properties and recent progress in rAAV production made it rapidly become the reagent of choice for therapeutic gene tmasfer.Over 60 clinical trials of gene therapy based on rAAV have been carried out.The dose response reaction between rAAV vectors and gene expression activity or clinical outcome is one of major aspects of these trials.Most studies showed that vector genomes(vg)and gene expression had a concentration-dependent relationship during a certain scope.However,gene expr~sion Can be afffected by viral serotypes,tissue tropisms,cell targeting,drug regulation,injection route,age and sex,etc.Thus,these aspects should be carefully comidered by scienti-sts,pharmacologisis and physicians during animal ex-periments or clinical trails.KEY WORDS gene therapy;viral vector;dose-re-sponse;quantitative pharmacology;clinical thempy