昆布多糖对肾纤维化大鼠肾组织内质网应激的保护作用

目的研究昆布多糖对肾纤维化大鼠肾组织内质网应激(ERS)分子伴侣GRP78、GRP94蛋白表达的影响。方法采用单侧输尿管梗阻(UUO)诱导大鼠肾间质纤维化的动物模型,将大鼠随机分为假手术组、模型组、依那普利组、昆布多糖高、中、低剂量组。术后第7天处死大鼠,收集血清测定肌酐(Scr)、尿素氮(BUN)水平。采用Western免疫印迹法检测大鼠肾组织GRP78、GRP94的蛋白表达;采用HE、Masson染色检测肾小管损伤及肾间质纤维化程度。结果各治疗组与模型组比较大鼠肾小管间质损伤指数、肾间质纤维化程度、血清Scr、BUN水平及肾组织GRP78、GRP94蛋白表达有差异(P<0.05;P<0.01),昆布多糖与依那普利组比较,大鼠肾组织GRP78、GRP94表达升高(P<0.05),肾小管间质损伤及肾间质纤维化程度明显降低(P<0.05),肾功能Scr、BUN明显降低(P<0.05)。结论UUO早期昆布多糖可能通过上调ERS分子伴侣GRP78、GRP94蛋白表达,协助变性蛋白进行重新折叠、装配及跨膜转运,抑制未折叠蛋白反应,阻断ERS应激信号传导通路,从而减轻肾间质纤维化的发生和发展。     

肾康注射液对慢性肾衰竭大鼠肾间质纤维化、内质网应激状态和线粒体氧化损伤的影响

目的 探索肾康注射液对慢性肾衰竭大鼠肾损伤及肾纤维化的作用机制。方法 采用腺嘌呤法建立大鼠慢性肾衰竭模型,采用叔丁基过氧化氢(TBHP)诱导NRK-52E细胞,建立慢性肾衰竭肾损伤细胞模型。采用苏木精–伊红(HE)染色评估肾康注射液对慢性肾衰竭大鼠的肾脏病理学损伤,免疫组化法检测模型大鼠肾损伤及纤维化的关键蛋白表达,免疫荧光法检测NRK-52E细胞葡萄糖调节蛋白78(GRP78)蛋白表达,Western blotting法进行肾组织和细胞中的关键蛋白定量,活性氧荧光探针检测NRK-52E细胞中的活性氧(ROS)水平,采用JC-1检测试剂盒检测NRK-52E细胞中线粒体膜电位水平。结果 肾康注射液可以显著缓解慢性肾衰竭大鼠的肾间质纤维化状态,减轻病理损伤;显著抑制肾损伤分子1(KIM-1)、GRP78、内质网应激相关蛋白(CHOP)阳性表达表达,从而抑制内质网过度应激状态;可显著抑制I型胶原蛋白(Collagen I)沉积,抑制α-平滑肌肌动蛋白(α-SMA)表达,从而抑制肾间质纤维化形成(P<0.01);肾康注射液能够显著抑制NRK-52E细胞内ROS的水平,减轻NRK-52E线...     

银杏叶提取物对肝纤维化大鼠肝组织GRP78及CHOP表达的影响

目的：观察银杏叶提取物（GbE）对肝纤维大鼠内质网应激通路相关分子GRP78、CHOP表达的影响,探讨GbE抗肝纤维的作用机制。方法：采用40％的CCl4皮下注射（3mL.Kg-1.d-1,2次/周,首剂加倍） 6周诱导大鼠肝纤维化模型,同时分别以200、100、50mg.Kg-1.d-1的GbE灌胃干预6周,空腹取肝组织,RealTime-PCR及免疫组化法分别检测肝组织GRP78及CHOP基因的mRNA及蛋白表达。结果：肝组织GRP78和CHOP的mRNA及蛋白的表达较正常组明显增加（P〈0.05 P〈0.01）;应用高、中、低剂量GbE干预后,大鼠肝组织GRP78和CHOP基因的mRNA及蛋白表达显著下降（P〈0.05 P〈0.01）。结论：肝纤维化大鼠肝脏发生了ERS反应,GbE下调肝纤维化大鼠肝组织内质网应激通路相关分子GRP78和CHOP的mRNA及蛋白的表达可能是其抗肝纤维化作用的机制之一。     

二氟甲基鸟氨酸对2型糖尿病大鼠心肌肥厚及内质网应激的影响

目的研究二氟甲基鸟氨酸(difluoromethylornithine,DFMO)对2型糖尿病(T2DM)大鼠心肌肥厚的作用,以及对内质网应激蛋白GRP78和CHOP的影响。方法采用高糖高脂膳食负荷链脲佐菌素(streptozotocin,STZ)单次腹腔注射,建立T2DM大鼠模型。实验大鼠分为正常对照组、T2DM模型组和DFMO治疗组,上述条件继续饲养12周。检测各组大鼠空腹血糖、心脏参数、心肌纤维化程度;测定MDA含量、SOD和T-AOC活性;检测GRP78和CHOP蛋白表达。结果 DFMO治疗后,降低T2DM大鼠空腹血糖和心脏参数(P<0.05),心肌间质纤维化程度下降(P<0.05),MDA含量降低,SOD和T-AOC活性增加。同时,DFMO治疗可以下调GRP78和CHOP蛋白表达水平(P<0.05)。结论 DFMO抑制T2DM大鼠心肌肥厚,机制与下调GRP78和CHOP蛋白表达,抑制内质网应激有关。     

氯沙坦抑制转录因子GADDl53/CHOP的激活在糖尿病大鼠肾脏中的保护作用

目的探讨血管紧张素Ⅱ受体1拮抗剂氯沙坦对糖尿病大鼠肾脏细胞凋亡及转录因子GADDl53/CHOP表达的影响。方法单侧肾切除大鼠腹腔注射链脲佐菌素诱发糖尿病,每日灌胃给予氯沙坦(40 mg.kg-1)共8周。应用免疫组织化学检测细胞增殖核抗原(Proliferating cell nuclear anti-gen,PCNA)、GRP78和转录因子GADDl53/CHOP的表达与定位,TUNEL染色检测细胞凋亡部位,流式细胞术检测细胞凋亡程度,并对GRP78、GADDl53/CHOP表达水平进行半定量分析,同时观察尿蛋白、BUN、Scr、Ucr等反应肾功能的相关指标。结果建模8周,糖尿病组大鼠较对照组肾小球、肾小管凋亡细胞数明显增多,GRP78、GADDl53/CHOP表达增强。氯沙坦治疗组较糖尿病组凋亡细胞数减少,GRP78表达减弱,明显抑制GADDl53/CHOP的表达。3组间PCNA阳性细胞数无差异。结论氯沙坦部分通过影响内质网应激中GADDl53/CHOP凋亡途径减少肾脏细胞凋亡,从而发挥肾脏保护作用。     

伊贝沙坦对肾间质纤维的保护及治疗作用实验研究

目的观察伊贝沙坦对单侧输尿管梗阻大鼠肾间质中PDGF-BB介导的肾间质纤维化的影响。方法制作大鼠肾间质纤维化模型,随机分为假手术组、模型组和伊贝沙坦治疗组,术后第7、14天分别处死各组中6只大鼠,检测大鼠肾功能、尿β2-微球蛋白,用免疫组化方法测定肾组织中α-平滑肌肌动蛋白(α-SMA)和血小板衍生生长因子(PDGF-BB)蛋白表达,动态观察肾脏病理变化。结果与输尿管梗阻核型(UUO)组比较,治疗组肾间质纤维化明显减轻(P<0.05),肾间质中α-SMA、PDGF-BB表达明显减少(P<0.05)。结论伊贝沙坦可通过下调肾间质PDGF-BB表达减轻肾组织间质纤维化。     

活性维生素D3抑制UUO模型大鼠肾间质纤维化作用的研究及其对TGF-β1,α-SMA表达的影响

目的:探讨活性维生素D3对单侧输尿管梗阻模型(UUO)大鼠肾小管间质纤维化的抑制作用,研究该病理过程中转化生长因子β1(TGF-β1),α-平滑肌肌动蛋白(α-SMA)的表达变化。方法:36只雄性Wistar大鼠,随机分为三组,活性维生素D3组、假手术组、模型组,每组12只。造模后活性维生素D3组给予罗盖全(骨化三醇)灌胃(3ng/100g),假手术组及UUO模型组给予等量生理盐水灌胃。三组大鼠于给药后第14天,28d分批(n=6)处死,留取造模侧肾脏。用HE染色及Masson染色法观察肾小管间质纤维化程度,用免疫组化法测定TGF-β1,α-SMA在各组大鼠造模侧肾脏的表达情况。结果:免疫组织化学显示:UUO模型组大鼠的肾脏组织中TGF-β1及α-SMA的表达显著高于假手术组(P<0.05),而在活性维生素D3治疗组中,TGF-β1及的α-SMA表达低于UUO模型组(P<0.05),肾脏组织形态学显示:模型组肾间质纤维化程度明显高于假手术组,活性维生素D3组肾间质纤维化程度明显小于模型组(P<0.05)。结论:活性维生素D3能有效抑制UUO大鼠肾间质中TGF-β1及α-SMA的表达,从而减轻UUO大鼠肾间质纤维化程度。     

阿托伐他汀对2型糖尿病大鼠心肌GRP78和CHOP表达的影响

探讨阿托伐他汀对2型糖尿病大鼠心肌组织内质网应激相关因子CCAAT/增强子结合蛋白同源蛋白（CHOP）和葡萄糖调节蛋白78（GRP78）表达的影响。将Wistar大鼠随机分为正常对照组（NC组）、糖尿病心肌病模型组（DCM组）和阿托伐他汀治疗组（DCM+Ato组）。采取高脂肪饲料喂养加一次性腹腔注射链脲佐菌素的方式制备2型糖尿病心肌病大鼠模型,DCM+Ato组大鼠予阿托伐他汀干预8周。采用左室插管评估大鼠心功能,HE染色观察心肌组织病理学改变,TUNEL法测定心肌细胞凋亡水平,Western blot检测心肌组织的GRP78和CHOP蛋白表达量。DCM组较NC组细胞肥大,排列紊乱,形态不规则,DCM+Ato组较DCM组改善。与NC组比较,DCM组左室舒张末期压（LVEDP）显著升高,左室收缩压（LVSP）和左室压力上升或下降最大速率（LV±dp/dt max）显著降低,细胞凋亡率升高,GRP78、CHOP表达明显升高（P＜0.05）;与DCM组比较,DCM+Ato组LVEDP显著降低,LVSP和LV±dp/dt max显著升高,细胞凋亡率降低,GRP78、CHOP表达明显下降（P＜0.05）。阿托伐他汀能有效减轻2型糖尿病大鼠的心肌病理损伤及改善心功能,可能与下调内质网应激相关因子GRP78、CHOP的表达,减少心肌细胞凋亡有关。     

Rofecoxib对肾间质纤维化大鼠TGF-及肾小管上皮细胞凋亡的影响

目的 探讨Rofecoxib对肾间质纤维化大鼠的肾脏保护机制。方法以UUO建立肾间质纤维化大鼠模型,随机分为假手术组、UUO组及Rofecoxib干预组,检测不同时间点肾脏COX-2、TGF-1及肾小管上皮细胞凋亡的表达。结果与假手术组相比,UUO组随着模型时间延长,TGF-β、COX-2蛋白表达明显增加,可检测到较多的凋亡细胞（P〈0．01）,用药组与UUO组平行相比TGF-β,、COX-2蛋白表达明显减少（P〈0．01）,凋亡细胞明显减少（P〈0．01）。结论特异性COX-2抑制剂Rofecoxib可能通过阻断UUO大鼠肾组织COX-2活性,下调TGF-的蛋白合成,减少肾小管细胞的过度凋亡,起到肾脏保护的作用。     

肾康注射液对单侧输尿管梗阻大鼠模型肾间质转化生长因子-β1和骨形成蛋白-7表达的影响

目的研究肾康注射液对单侧输尿管梗阻（UUO）大鼠模型肾间质转化生长因子-β1（TGF-β1）和骨形成蛋白-7（BMP-7）表达的影响。方法将SD雌性大鼠54只随机分为正常对照组、UUO模型组、肾康治疗组，肾康治疗组用肾康注射液灌胃，分别在手术后第5，10，15天处死大鼠，在光镜下观察肾组织病理改变，应用免疫组织化学方法检测肾小管间质中TGF-β1，和BMP-7表达。结果与正常对照组相比，UUO模型组大鼠肾脏TGF-β1表达明显升高，BMP-7表达明显减少，但在予肾康注射液治疗后能显著下调UUO模型大鼠TGF-β1表达，上调BMP-7表达。结论肾康注射液可减轻肾小管间质纤维化，延缓慢性肾功能衰竭进展。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

基层医院护士在临床合理用药中的作用

目的充分利用护士在医师和患者间的特殊地位和作用,促进基层临床合理用药。方法从护士的工作性质出发,论述护士参与促进合理用药的方便和优势。结果通过实践,护士在促进合理用药中的作用得到有效发挥,基层合理用药环境得到极大改善。结论充分利用护士与医师和患者间的特殊桥梁作用,在基层医院促进合理用药,规范医师用药行为,防止药物滥用,引导患者安全用药,降低药源性疾病。