缬沙坦和螺内酯对高血压大鼠心肌生长因子和Ⅰ型胶原mRNA表达的影响

本研究旨在观察盐皮质激素受体拮抗剂螺内酯对自发性高血压大鼠 (SHR)心肌中生长因子和Ⅰ型胶原的影响 ,探讨螺内酯改善心肌重塑和心力衰竭患者预后的作用机制。一、材料和方法1.实验动物及分组 :选用 6周龄雄性SHR18只 ,体重 ( 82 .67± 11.3 7) g ,随机分为 3组 ,每组各 6只 ,分别设为SHR阳性对照组、缬沙坦治疗组、螺内酯治疗组 ,6只WKY大鼠作为正常对照组。2 .药物及给药方法 :两治疗组分别给予缬沙坦 (诺华公司 ) 3 0mg·kg-1·d-1、螺内酯 (江苏盐城制药厂 ) 2 0mg·kg-1·d-1溶于饮水灌胃 ,每天 1次 ,连续治疗 13周 ;两对照组不…     

肝细胞生长因子在环孢素A肾病大鼠肾组织中的表达意义

目的　探讨肝细胞生长因子 (HGF)在环孢素A(CsA)肾病大鼠肾组织中的表达及意义。　方法　 2 8只SD大鼠低盐饮食饲养 7d后 ,随机分为对照组、CsA组、CsA加维拉帕米组、CsA加依那普利组。每组 7只。除对照组外 ,其余 3组大鼠皮下注射CsA 15mg·kg-1·d-1,采用放射免疫法检测各组动物血管紧张素Ⅱ (AngⅡ )水平 ;Northernblot、原位杂交检测肾组织HGFmRNA的表达。对各组动物肾小管损伤进行半定量计分。　结果　CsA处理组肾组织AngⅡ水平均明显高于对照组 :(2 9.8± 6.0 )vs (8.7± 1.7)ng/g肾组织 ,P <0 .0 0 1,HGFmRNA表达也明显减少。依那普利组肾组织AngⅡ水平明显降低 ,HGFmRNA表达增加 ,P <0 .0 5。依那普利能明显减轻CsA引起的肾小管损伤 ,异博定对肾小管损伤无显著改善。肾组织HGFmRNA表达与肾小管损伤呈负相关 ,P <0 .0 5。　结论　肾素血管紧张素系统 (RAS)的激活使HGFmRNA表达下调 ,阻断RAS可以使HGFmRNA表达增加 ,减轻CsA引起的肾小管损伤     

缬沙坦与螺内酯联合应用对单侧输尿管梗阻大鼠肾间质纤维化的影响

目的:探讨缬沙坦与螺内酯联合应用对单侧输尿管梗阻大鼠肾间质纤维化的影响。方法:取6周龄SD大鼠50只,随机分为正常组、模型组、缬沙坦组、螺内酯组及缬沙坦+螺内酯联合治疗组,每组10只。采用单侧输尿管梗阻(UUO)大鼠模型。正常组及模型组给予生理盐水10 ml·kg~(-1)·d~(-1)灌胃,治疗组均给予缬沙坦10 mg·kg~(-1)·d~(-1)、螺内酯100 mg·kg~(-1)·d~(-1)灌胃、缬沙坦10 mg·kg~(-1)·d~(-1)+螺内酯100 mg·kg~(-1)·d~(-1)灌胃,各组大鼠均于术后2周后处死。肾组织行HE染色及逆转录聚合酶链反应(RT-PCR)法观察梗阻肾组织TGF-β1mRNA、BMP-7 mRNA的表达。结果:与假手术组相比,模型组的TGF-β1mRNA表达增多(P0.05),BMP-7 mRNA表达则显著降低,三组治疗组TGF-β1mRNA表达显著低于模型组(P值均0.05),而BMP-7mRNA表达则显著增加。联合治疗组与缬沙坦、螺内酯组的差异均有统计学意义(P值均0.05)。结论:与单用缬沙坦、螺内酯相比,联合治疗能减轻UUO大鼠肾间质纤维化。     

螺内酯对单侧输尿管梗阻大鼠肾脏的保护作用

目的观察螺内酯对单侧输尿管梗阻(UUO)大鼠肾皮质金属蛋白酶1组织抑制剂(TIMP-1)介导的肾间质纤维化的影响。方法UUO大鼠给予螺内酯20mg·kg-1·d-1灌胃,用免疫组化及RT-PCR的方法检测术后7d、14d、21d的TIMP-1表达量并观察肾脏病理改变。结果与假手术组相比,UUO组及螺内酯组的TIMP-1mRNA和TIMP-1蛋白表达水平均明显增高(P<0.01),且UUO组显著高于螺内酯组(P<0.01)。结论螺内酯可通过下调TIMP-1减轻UUO术后肾组织间质纤维化。     

抗高血压药物对自发性高血压大鼠勃起功能和nNOS神经纤维的影响

目的 :研究抗高血压药物对自发性高血压大鼠 (SHR)勃起功能和神经元型一氧化氮合酶 (nNOS)神经纤维的影响。　方法 :18只 6周龄雄性SHR随机均分为 3组 :缬沙坦 [30mg (kg·d) ]干预组、螺内酯 [2 0mg (kg·d) ]干预组和对照组。 12周后 ,观察大鼠阴茎勃起功能 ,并用免疫组化SP法检测阴茎组织中nNOS神经纤维的数目。　结果 :缬沙坦干预组勃起次数与另外两组相比差异有显著性 (P <0 .0 5 ) ,后两组之间差异无显著性 (P >0 .0 5 ) ,勃起率 3组之间差异不明显 (P >0 .0 5 ) ,阴茎组织中nNOS神经纤维数目 ,两干预组与对照组之间差异有显著性 (P <0 .0 1) ,而两干预组之间差异无显著性 (P >0 .0 5 )。　结论 :缬沙坦能改善SHR的勃起功能 ,而螺内酯无改善作用 ,这种差异与nNOS神经纤维数目无关 ,可能与血管紧张素Ⅱ(AngⅡ)受体阻滞剂引起血管重构等其他作用有关     

天生饮对肾血管性高血压大鼠肾Smad3和Smad7表达的影响

目的：研究天生饮对肾血管性高血压大鼠肾Smad3和Smad7表达的影响。方法：将清洁级SD大鼠随机分成正常组、假手术组、手术组。实验大鼠适应性喂养1周,采用二肾-夹法复制肾血管性高血压大鼠模型,手术组均在无菌条件下进行左侧肾动脉夹窄术,假手术组只分离左侧肾动脉不夹,正常组不作任何处理。术后第4周,将造模成功的手术组大鼠随机分为模型组和天生饮组。天生饮组每天给予天生饮灌胃,模型组、假手术组和正常组以蒸馏水灌胃,连续灌胃4周后处死所有动物。用HE方法观察左肾组织形态学改变,用免疫组化法分别检测大鼠左肾组织中Smad3和Smad7的表达。结果：模型组大鼠与正常组、假手术组比较：血压、BUN及Scr升高,肾纤维化程度增加,Smad3的表达量上调,Smad7的表达量下调,以上组间的差异均具有统计学意义（P〈0.01）;经天生饮治疗4周后,天生饮组大鼠与模型组比较：肾纤维化程度减轻,Smad3的表达量下调,Smad7的表达量上调,组间差异具有统计学意义（P〈0.01）。结论：天生饮能够减轻两肾-夹肾血管性高血压大鼠肾纤维化程度,且其疗效机制可能是通过降低Smad3的表达和促进Smad7的表达。     

缬沙坦通过上调肾皮质Megalin的表达减少自发性高血压大鼠肾小管性蛋白尿

目的:研究缬沙坦是否可通过上调近端肾小管多配体的胞吞受体Megalin的表达,从而减少自发性高血压大鼠(SHR)肾小管性蛋白尿。方法:选取14周龄雄性SHR72只,随机分为3组,每组24只,分组:缬沙坦组(50 mg·kg-1·d-1,SHR-V);氨氯地平组(10 mg·kg-1·d-1,SHR-A);空白对照组(SHR)。灌胃法给药7周,用药前后均测定血压。7周后处死大鼠,取出肾组织,免疫印迹法(WB)测定各组大鼠肾皮质中Megalin的表达含量。结果:SHR-V与SHR-A组降低系统性高血压的程度相当。SHR-V组降低白蛋白尿作用明显优于SHR-A组(P=0.01)。SHR-V与SHR-A、SHR组比较,可以显著减少肾小管性蛋白尿,这与SHR-V组Megalin表达上调相关(135±28%)。结论:血管紧张素Ⅱ受体拮抗剂缬沙坦具有非血压依赖的肾脏保护作用,与肾皮质Megalin表达上调密切相关。此外,肾小管衰竭是高血压患者发生蛋白尿的重要机制之一。     

肾疏宁抑制腹膜透析腹膜纤维化大鼠基质及新生血管的实验研究

目的:观察中药肾疏宁对腹膜纤维化大鼠腹膜功能、腹膜组织基质积聚、新生血管、结缔组织生长因子(CT-GF)、血管内皮生长因子(VEGF)、肝细胞生长因子(HGF)及骨形态蛋白-7(BMP-7)表达的影响。方法:腹膜透析液+阿霉素注射法诱发SD大鼠腹膜透析腹膜纤维化模型,依体重随机分为4组,1.5%腹膜透析液模型组、4.25%腹膜透析液模型组、1.5%腹膜透析液+肾疏宁干预组及4.25%腹膜透析液+肾疏宁干预组,每组各15只,另设空白对照组(对照组,15只)。1.5%腹膜透析液+肾疏宁干预组及4.25%腹膜透析液+肾疏宁干预组予肾疏宁(按43.93g.kg-1.d-1)灌胃,对照组和模型组予等量生理盐水灌胃。检测腹透液葡萄糖浓度,计算超滤量(UF)及葡萄糖转运量(MGT)。观察腹膜病理形态学改变,分析腹膜厚度、腹膜血管计数、腹膜纤维连接蛋白(FN)及CTGF、VEGF、HGF、BMP-7表达。结果:治疗第6周末,1.5%腹膜透析液+肾疏宁干预组及4.25%腹膜透析液+肾疏宁干预组腹膜透析腹膜纤维化大鼠超滤量(-3.26±14.17)ml及(-2.04±10.74)ml、葡萄糖转运量(18.12±0.81)mmol/kg及(16.14±1.20)mmol/kg、腹膜厚度(74.68±15.33)μm及(211.75±58.23)μm、腹膜血管计数(8.21±2.66)个/mm2及(13.70±4.71)个/mm2、FN(152.47±36.94)%及(231.49±53.49)%、CTGF(708.67±127.22)%及(791.20±126.37)%、VEGF(0.42±0.08)%及(0.50±0.09)%、HGF(245.71±24.38)%及(222.05±23.43)%、BMP-7(351.27±31.99)%及(284.43±26.82)%,与同浓度透析液组比较,差异有统计学意义(P<0.05,P<0.01)。结论:肾疏宁可能通过调控CTGF、VEGF、HGF、BMP-7表达,阻抑基质过度积聚及新生血管生成,进而延缓腹膜透析大鼠腹膜纤维化进展。     

辛伐他汀对大鼠肾缺血再灌注损伤中Wnt/JNK影响的研究

目的:探讨辛伐他汀(simvastatin SIM)对大鼠肾缺血再灌注损伤中Wnt/JNK的影响。方法:雄性wistar大鼠36只随机分为:假手术组、手术组、SIM干预组,每组12只,再将每组按取材时间不同分为6 h、48 h两个时相组。手术方法:假手术组开腹分离双侧肾动脉,但不夹闭,后关闭腹腔;手术组游离双侧肾动脉,动脉夹夹闭45 min后恢复灌注建立肾IRI模型;SIM干预组术前1周给大鼠灌胃SIM 20 mg.kg-1.d-1,其余处理同手术组。肾IRI后6 h、48 h,检测血清Scr值,肾组织行病理学观察及免疫组织化学法测定Wnt4、JNK1及其信号通路下游炎症因子TNFα的表达,并采用real time PCR法测定肾组织Wnt4 mRNA、JNK1 mRNA的表达。结果:肾组织病理学观察:假手术组肾组织形态结构基本正常;手术组肾小管上皮细胞有不同程度的肿胀、坏死和脱落、排列紊乱,管腔扩张,肾间质水肿、炎细胞浸润明显,以IRI后6 h为著;SIM干预组肾组织损伤程度较手术组明显减轻。Scr值测定:手术组Scr值较假手术组明显升高(P<0.01);SIM干预组Scr值较手术组有所下降(P<0.01);以IRI后6 h,Scr值较高(P<0.01)。免疫组化检测:假手术组肾小管上皮细胞Wnt4、JNK1、TNFα表达较弱;手术组IRI后肾小管上皮细胞胞浆内Wnt4、JNK1、TNFα表达均比假手术组增强(P<0.01),以6 h时为著(P<0.01)。SIM干预组Wnt4、JNK1、TNFα表达水平较手术组减弱(P<0.05)。real time PCR检测:假手术组肾小管上皮细胞Wnt4 mRNA、JNK1 mRNA表达较弱;手术组肾小管上皮细胞Wnt4 mRNA、JNK1 mRNA表达均较假手术组增强(P<0.01),以6 h为著(P<0.01);SIM干预组Wnt4 mRNA、JNK1 mRNA表达比手术组均有所下降(P<0.01)。相关性分析:JNK1与Wnt4、TNFα均成正相关(rs=0.94,rs=0.95);Wnt4 mRNA、JNK1 mRNA成正相关(rs=0.75);且均与Scr成正相关(rs分别为rs=0.93,rs=0.96,rs=0.94,rs=0.70,rs=0.35)。结论:辛伐他汀预处理可能通过抑制Wnt/JNK信号通路的表达,从而减轻肾IRI程度。     

螺内酯对糖尿病大鼠肾小球保护作用的机制探讨

目的 观察螺内酯对糖尿病大鼠肾小球的保护作用并探讨其机制。 方法 将SD大鼠随机分为健康对照组、病理组、螺内酯治疗组。治疗30 d后处死，观察肾小球病理形态变化；RT-PCR法观察肾脏皮质纤溶酶原激活剂抑制物1(PAI-1) 和转化生长因子β1(TGF-β1)mRNA的变化； Western印迹法观察肾脏皮质PAI-1的表达；免疫组化方法观察肾脏皮质TGF-β1、纤连蛋白(FN)变化及检测肾皮质丙二醛(MDA) 含量、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px) 、总抗氧化能力(T-AOC)活性。 结果 与病理组比，螺内酯治疗后可下调肾皮质TGF-β1、PAI-1 mRNA与蛋白表达（P均< 0.05）；降低肾皮质MDA水平[（0.95±0.20）比（1.23±0.31） nmol/mg，P < 0.05]；增强SOD、GSH-Px、T-AOC活性[分别为（550.19±20.06）比（509.53±33.25） U/mg，（21.67±2.70）比（18.91±2.30） U/mg，（1.15±0.21）比（0.86±0.26） U/mg，P均< 0.05]；减少FN在肾小球的沉积(P < 0.01)；改善肾小球的病理状况。 结论 螺内酯可能通过下调糖尿病大鼠肾皮质TGF-β1、PAI-1表达，降低肾皮质氧化应激水平，起到保护糖尿病大鼠肾脏，延缓肾小球硬化的作用。     

Soluble Fas and Fas-ligand in bladder cancer in vitro and in vivo

Circulating soluble Fas (sFas) and expression of Fas-ligand on cancer cells are mechanisms of immune escape. The aim of the present study was to investigate expression and production of Fas and Fas-ligand on bladder cancer cell lines of different grade as a basic mechanism of their secretion in vivo. sFas and sFas-ligand serum levels of patients with different stage of bladder cancer were examined to determine the possible clinical use of these molecules as tumor markers. Bladder cancer cell lines RT4 (G1), RT112 (G1), T24 (G3) and SUP (G4) were analyzed by flowcytometry for Fas and Fas-ligand expression. To determine if the Fas-ligand gene is transcribed in these bladder cancer cell lines, RT-PCR was performed on mRNA extracted from these cell lines. Production of sFas and sFas-ligand was examined in cell culture supernatants of the cancer cells as well as in the serum of 62 patients with bladder cancer by a specific ELISA test. We demonstrate that Fas is expressed in similar levels on all human bladder carcinoma cell lines. In T24 (G3) and SUP (G4) cell lines we were able to detect the Fas-ligand protein, whereas no Fas-ligand protein could be found in RT4 and RT112 (G1) cells. Fas-ligand mRNA was expressed in all bladder cancer cell lines. Furthermore, all bladder cancer cell lines produce sFas but no sFas-ligand in spite of mRNA expression. The range of sFas levels in the serum of all patients with bladder cancer was large and did not show a correlation to the histopathological stage of bladder cancer. Although there is in vitro evidence that sFas and Fas-ligand play a role in bladder cancer, no correlation between the sFas and s Fas-ligand serum levels and the histopathological stage of bladder cancer could be found. Therefore, serum sFas and sFas-ligand have to date limited clinical relevance.     

Predominantly posterior instrumentation and fusion in neuromuscular and neurogenic scoliosis in children and adolescents

We studied the results in 46 patients with neuromuscular and neurogenic scoliosis (average age 13.5 years, range 6–19 years) who had had posterior fusion with a modified Luque technique between May 1985 and June 1992. The main criteria to recommend surgery were curve progression, loss of balance when sitting, control of the head and difficulties in wearing an external orthotic support. The mean preoperative curve was 63°, the postoperative value was 24°, representing a correction of about 62%. The average number of stabilized segments was 13. In 39 out of 46 patients, lumbosacral fixation was included in the construct. Failure of implants, pseudarthroses and major losses of correction in purely neuromuscular scolioses could be avoided by using rigid segmental fixation and a dorsolateral fusion with a mixture of autologous and allogenous bone. The scoliosis most difficult to influence was found to be Friedreich's ataxia. In Duchenne muscular dystrophy the best method of treatment was surgery performed as early as possible, i.e. at the time of loss of walking capacity in the case of a scoliosis exceeding 20° and with two consecutive X-rays proving curve progression. Analysis of our series does not confirm the morbidity and complication rates of previous studies.     

Culture and characterisation of human urothelium in vivo and in vitro

The aim of this study was to culture human urothelium and generate enough cells for subsequent reconstructive surgery. Using a modification of the Rheinwald-Green method for the routine culture of keratinocytes from patients with burns, we successfully cultured 91% of 57 biopsies from the renal pelvis, ureter, bladder and urethra of paediatric patients. The cells could be split one to three up to 9 times at 7–10 day intervals, giving a surface area of 1000 cm² after a 2 month culture period. Primary cultures could not be initiated in defined medium MCDB153, although cells initiated using the Rheinwald-Green method could subsequently be propagated in this medium. Cytokeratin patterns in vitro were similar to those in vivo in the expression of keratins 7, 18 and 19 (characteristic of simple epithelia) and keratin 13 (characteristic of non-cornified stratified epithelia). Cultured urothelium also expressed keratin 14 (characteristic of cornified stratified epithelium) in about 25% of cells and keratin 16 (characteristic of fast-growing cells). These findings indicate that urothelial cells can be propagated in vitro for autologous grafting, and the next step is to identify substrates suitable for urothelial cell growth and differentiation and surgical manipulation.     

Overweight in childhood and bone density and size in adulthood

Summary  

We evaluated the adult bone structural traits in relation to childhood overweight in 832 men and women. Childhood overweight was associated with larger cross-sections at long bones in both sexes. Excess weight in childhood may also lead to higher trabecular density in females and somewhat lower cortical density in men.