Ezrin蛋白在老年多发性肌炎患者骨骼肌中的表达

目的探讨Ezrin蛋白在老年多发性肌炎患者骨骼肌中的表达。方法选取12例老年多发性肌炎患者骨骼肌标本,冰冻连续切片,HE及酸性磷酸酶组织化学染色;抗-Ezrin蛋白单克隆抗体免疫组织化学染色,对比观察同源肌纤维染色情况。结果 Ezrin蛋白在炎性细胞浸润的血管周围及肌间隙内呈阳性表达,在正常肌纤维上表达不明显。结论 Ezrin蛋白在老年多发性肌炎患者骨骼肌中与炎性反应关系密切。     

包涵体肌炎的临床和病理分析

目的探讨包涵体肌炎的临床和病理特点。方法分析20例包涵体肌炎患者的临床、骨骼肌活检组织化学染色及电镜病理特点。结果骨骼肌活检组织化学染色病理特点：肌周膜、肌内膜、血管周围炎性细胞浸润,肌纤维大小不等,散在变性、坏死和再生肌纤维,结缔组织增生,肌纤维内可见边缘空泡,空泡周边淀粉样物质沉积,可伴破碎红纤维、肌纤维类型或分布异常。电镜：肌原纤维结构紊乱,Z线排列不整或消失,肌浆包涵体内可见大量髓磷脂小体和吞噬空泡聚集,周边可见脂滴、糖原颗粒。结论包涵体肌炎临床诊断、鉴别诊断困难,骨骼肌活检病理分析是确诊本病的可靠标准。     

经冠状动脉注射法移植成年犬自体骨骼肌成肌细胞于急性心肌梗死区的病理研究

目的观察冠状动脉内注射法移植自体骨骼肌成肌细胞到无再灌注急性心肌梗死区后的生长分化特点。方法结扎犬冠状动脉前降支中段,建立急性心肌梗死模型;杂种成年犬10只,分为对照组和经冠状动脉注射移植组,各5只。经梗死相关冠状动脉内注射自体骨骼肌成肌细胞悬液10 ml(1.0~1.4×108个)或等量生理盐水;4周后通过HE染色、PTH染色、骨骼肌特异性慢肌球蛋白抗体免疫组织化学染色和透射电镜评价移植细胞病理转归。结果经冠状动脉内注射移植自体骨骼肌成肌细胞4周后,透射电镜及HE染色下可在梗死区内找到新生幼稚肌源性细胞存在,PTH染色证实有新生的横纹肌组织形成,骨骼肌特异性慢肌球蛋白抗体免疫组织化学染色发现有骨骼肌源性的成熟肌组织存在且新生肌组织排列较分散。结论通过经梗死相关冠状动脉注射将自体骨骼肌成肌细胞移植到急性心肌梗死区后能形成成熟的肌组织。     

抗信号识别颗粒抗体肌病八例临床分析

目的 总结抗信号识别颗粒抗体肌病患者的临床和骨骼肌病理改变特点.方法 选择8例患者采取免疫印迹法测定血清肌炎抗体谱并进行肌肉活检,肌肉标本进行组织学、酶组织化学和免疫组织化学染色.免疫组织化学染色的第一抗体为鼠抗人CD8、CD20、CD68单克隆抗体,分别标记T细胞、B细胞和巨噬细胞,主要组织相容性复合体(MHC)-Ⅰ单克隆抗体标记肌纤维膜,CD31单克隆抗体标记毛细血管内皮细胞.结果 8例患者血清抗信号识别颗粒抗体均为强阳性,其中3例伴随Ro-52抗体阳性.8例患者骨骼肌出现肌纤维坏死、再生以及巨噬细胞浸润,2例患者伴随肌纤维肥大和间质增生,2例伴随少数T细胞浸润.存在部分MHC-Ⅰ阳性肌纤维,毛细血管密度正常.结论 抗信号识别颗粒抗体肌病以缓慢发病的肢体无力为主要表现,可伴肺部病变.肌纤维坏死、再生为其主要病理改变,可以类似肌营养不良改变.     

天龙液对实验性自身免疫性肌炎豚鼠模型中肝脏损伤的治疗作用

目的 采用多发性肌炎(PM)的豚鼠模型,检测血清肝功指标及肝脏病理变化,并观察天龙液对肝脏损害的治疗作用.方法 用兔肌肉匀浆加完全佛氏佐剂免疫注射豚鼠造成实验性自身免疫性肌炎(EAM)动物模型,将EAM豚鼠随机分为4组模型组,对照组(给予生理盐水10 ml·kg-1·d-1),泼尼松组(给予泼尼松3 mg·Kg-1·d-1治疗)和天龙液组(给予天龙液3 750 mg·Kg-1·d-1治疗),比较各组间血清肌酶、肝功指标及肝脏病理改变.结果 模型制作后血清ALT、AsT、GGT显著升高(P＜0.05),肝脏病理出现轻度炎性改变;天龙液组治疗后肝脏损害改变好转(P＜0.05).结论 EAM豚鼠出现肝功改变,天龙液对此肝脏损害有治疗作用.     

慢性阻塞性肺疾病大鼠模型骨骼肌组织氧化应激损伤的研究

目的研究不同烟熏强度对SD大鼠骨骼肌组织氧化应激损伤,探讨慢性阻塞性肺疾病骨骼肌功能障碍的机制。方法 40只SD大鼠随机分为对照组、实验1组、实验2组、实验3组,每组各10只。实验1组、实验2组、实验3组分别给予4周、12周、20周的烟熏制作慢性阻塞性肺疾病动物模型,烟熏结束后肺组织制作病理标本观察其变化,并取大鼠双侧伸趾长肌,用ELISA方法检测各组大鼠的伸趾长肌组织匀浆丙二醛(MDA)的浓度、伸趾长肌组织蛋白质提取液羰基化蛋白(PC)的浓度、伸趾长肌组织DNA中8-羟基脱氧鸟苷(8-OHdG)的含量。结果光镜下大鼠肺组织随着烟熏强度的增加,其肺组织炎性细胞浸润、肺泡壁破坏相应更为显著。与对照组相比,实验2组、实验3组MDA、8-OHdG显著增高(P0.05-P0.01),实验3组PC显著增高(P0.05)。结论烟熏不仅可导致大鼠肺组织炎症加重、肺泡结构破坏,还可导致其骨骼肌组织氧化应激损伤。     

多发性肌炎和皮肌炎的诊治进展

特发性炎性肌病（idiopathic inflammatory myopathies，IIM）是一组病因不明的以横纹肌肌纤维变性、坏死及炎性细胞浸润为特征的自身免疫性疾病。临床上IIM主要包括多发性肌炎（polymyositis，PM）、皮肌炎（dermatomyosifis，DM）和包涵体肌炎（inclusionbody myositis，IBM）三种类型。现就PM和DM的免疫病理机制、诊断和治疗等方面的研究进展进行综述。     

百日咳毒素通过诱导中性粒细胞胞外诱捕网形成参与实验性自身免疫性肌炎小鼠间质性肺疾病的发生

目的旨在明确百日咳毒素(PTX)能否促进实验性自身免疫性肌炎(EAM)模型间质性肺疾病(ILD)的发生并探究其潜在的致病机制。方法构建单用骨骼肌匀浆或骨骼肌匀浆联合PTX诱导的EAM模型, 通过组织病理学、血清学研究明确PTX与EAM小鼠ILD表型及中性粒细胞胞外诱捕网(NETs)的关系;健康小鼠单独给予PTX腹腔注射, 明确是否能在体内诱发NETs形成, PTX体外干预健康人中性粒细胞明确能否诱发NETs形成。计量资料使用Shapiro-Wilk正态性检验, 采用t检验或单因素方差分析, 采用图基事后检验(Tukey)进一步比较组间差异。结果与单用骨骼肌匀浆组相比, 使用骨骼肌匀浆联合PTX组的EAM模型肺组织有着类似于多发性肌炎/皮肌炎(PM/DM)相关ILD的多种病理学改变, 以非特异型间质性肺炎、普通型间质性肺炎为主要类型;EAM组肺间质伴有明显的NETs浸润;EAM组血清NETs标记物水平明显升高, 与对照组[n=5, (87±10)ng/ml]相比, 肌匀浆组[n=4, (115±27)ng/ml]和EAM组[n=7, (150±50)ng/ml]循环核酸(cfDNA)水平...     

特发性炎性肌病骨骼肌炎症浸润的组织病理学分析

目的：研究多发性肌炎（PM）和皮肌炎（DM）患者骨骼肌组织中浸润的炎性细胞的类型、分布和定位，探讨它们在特发性炎性肌病（IIM）发病机制中的作用。方法；选取IIM患者肌肉组织标本45例，其中PM19例，DM26例。用免疫组织化学方法检测PM／DM患者骨骼肌组织中CD3、CD4、CD8、CD20、CD45RA和CD45RO分子的表达。结果：PM组肌组织的损伤主要表现为肌纤维坏死和肌内膜炎，而DM组主要表现为束周萎缩和血管周围炎。CD3、CD8和CD45RO分子在PM和DM患者肌组织中均有阳性表达，两组间表达量差异无统计学意义（P均〉0．05），主要分布在PM／DM患者肌组织的肌内膜和血管周围处。而CD20、CD4、CD45RA分子在DM组的阳性表达量较PM组明显增多（P均〈O．05），且主要分布在血管周围。结论：细胞免疫和体液免疫均参与了PM和DM的发病，而体液免疫在DM的发病中可能起更主要的作用。     

线粒体氧化应激在心肌缺血性损伤中的作用

目的 探讨线粒体氧化应激在腹腔注射异丙肾上腺素构建的无创性大鼠心肌缺血缺氧模型中的作用.方法 16只SD大鼠随机分为两组:对照组8只,实验组8只.间隔24 h腹腔注射5 mg/kg异丙肾上腺素,对照组则注射等量生理盐水.对照组和实验组于第3次注射后24 h处死.各组大鼠处死前取血清进行心肌酶检测,常规 HE 及8-OhDG和Caspase-3免疫组织化学染色.结果 实验组,对照组的乳酸脱氢酶(LDH)分别为(6 762.70±786.76)U/L、(4 317.60±690.82)U/L,两组间差异具有统计学意义(P<0.01);实验组,对照组血清磷酸激酸(CK)分别为(58.32±5.76)U/ml、(43.69±4.82)U/ml,两组间差异具有统计学意义(P<0.01).HE染色显示实验组局部心肌组织变性坏死,伴有炎细胞浸润;对照组心肌无异常.实验组免疫组织化学染色可见大量心肌细胞质表达8-OhDG和Caspase-3;对照组无表达.结论 腹腔大剂量注射异丙肾上腺素构建的心肌缺血缺氧损伤模型,其机制在于氧化应激导致的心肌细胞线粒体DNA损伤,并通过Caspase-3路径诱导心肌细胞凋亡.本研究对于心肌缺血缺氧的发病机制提供了新视点,以保护线粒体为切入点,为临床对症治疗提供了新思路.     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.