细胞内活性氧在糖基化终末产物促人腹膜间皮细胞分泌血管内皮生长因子中的作用

目的:观察糖基化终末产物(AGEs)对人腹膜间皮细胞(HPMC)分泌血管内皮生长因子(VEGF)的影响及细胞内活性氧(ROS)在其中的作用。方法:分别用不同浓度的AGE-HSA及抗氧化剂N-酰-L-半胱氨酸(NAC)作用于细胞,用RT-PCR和ELISA方法测定HPMC中VEGF的表达;再以氧化敏感的荧光染料2、7-二氢二氯荧光素(DCFH)染色,流式细胞仪测定细胞内活性氧强度。结果:AGE-HSA能使细胞内ROS水平明显升高,呈现浓度依赖效应;AGE-HSA同时以时效和量效方式促进HPMC中VEGF的表达;而NAC能够明显抑制AGE-HSA所导致的细胞内ROS升高,同时抑制HPMC中VEGF的分泌。结论:AGE-HSA可能部分通过诱导细胞内ROS,促进HPMC表达VEGF,从而引起腹膜新生血管的增加,最终导致腹膜失超滤现象。     

活血通腑方含药血清对大鼠腹膜间皮细胞增殖的作用

目的观察活血通腑方含药血清干预体外培养大鼠腹膜间皮细胞增殖的效果,初筛对大鼠腹膜间皮细胞增殖能力有影响的最佳药物剂量和时间。方法采用腹腔注射胰酶消化的方式建立RPMC细胞模型,运用血清药理学方法制备不同剂量的活血通腑方含药血清,细胞培养经鉴定成功后分组(空白组、空白血清组、活血通腑方低剂量组、活血通腑方中剂量组、活血通腑方高剂量组),应用MTT法检测活血通腑方含药血清对大鼠腹膜间皮细胞的作用。结果与空白血清组比较,活血通腑方中剂量组含药血清可显著促进RPMC细胞增殖,作用时间在36 h时最为显著。结论活血通腑方含药血清具有诱导大鼠腹膜间皮细胞增殖的作用。     

细胞内活性氧在甲基乙二醛促人腹膜间皮细胞分泌血管内皮生长因子中的作用

目的：观察葡萄糖降解产物甲基乙二醛（MGO）对人腹膜间皮细胞（HPMC）分泌血管内皮生长因子（VEGF）的影响及细胞内活性氧（ROS）在其中的作用。方法：分别用不同浓度的MGO及抗氧化剂N-酰-L-半胱氨酸（NAC）作用于细胞，用RT-PCR和ELISA方法测定HPMC中VEGF的表达；再以氧化敏感的荧光染料2、7-二氢二氯荧光素（DCFH）染色，流式细胞仪测定细胞内ROS强度。结果：MGO能使细胞内ROS水平明显升高，呈浓度依赖效应；MGO同时以时效和量效方式促进HPMC中VEGF的表达；而NAC能够明显抑制MGO导致的细胞内ROS升高，同时抑制HPMC中VEGF的分泌。结论：MGO可能部分通过诱导细胞内ROS，促进HPMC表达VEGF，从而引起腹膜新生血管的增加，最终导致腹膜失超滤现象。     

环氧化酶-2抑制剂对人腹膜间皮细胞转化生长因子-β1表达的影响

目的:研究环氧化酶-2(COX-2)抑制剂对人腹膜间皮细胞(HPMC)转化生长因子-1(TGF-1)表达的影响。 方法:采用胰蛋白酶消化法从人腹膜组织中分离间皮细胞,建立稳定的体外培养模型。用COX-2抑制剂干预高糖(4.25%D-葡萄糖)和细菌脂多糖(LPS)刺激下的HPMC。采用逆转录多聚酶链式反应(RT-PCR)半定量分析HPMC中TGF-1 mRNA的表达。采用双抗夹心法酶联免疫吸附实验检测HPMC培养液中TGF-1蛋白质水平。 结果:HPMC在高糖和LPS的刺激下可明显上调TGF-1的表达(P<0.01),COX-2抑制剂干预组(20nmol/L,40nmol/L, 60nmol/L)明显下调TGF-1的表达(P<0.05)。 结论:COX-2抑制剂能够明显抑制在高糖和LPS的刺激下的HPMC TGF-1的基因表达,为临床用COX-2抑制剂防治腹膜透析患者的腹膜纤维化提供实验和理论依据。     

腹膜透析液对小鼠腹膜间皮细胞超微结构影响的比较研究

作者通过模拟ＣＡＰＤ动物实验，应用扫描电镜观察比较了不同的腹透液对正常小鼠腹膜超微结构的影响，实验结果发现，随着注药时间延长，实验小鼠腹膜间皮细胞游离面微绒毛与间皮细胞的损害逐渐加重；三组腹透液对腹膜间皮影响是不相同的，Ｂａｘｔｅｒ腹透液对腹膜间皮损伤较严重，其中又以醋酸盐腹膜液为甚，注药后２１ｄ，乳酸盐和醋酸盐组均可见轻至中度的纤维素性粘连形成，停止注药后１０ｄ，腹膜间皮损伤基本恢复正常。本文结     

体外转化生长因子—β1与表皮生长因子对人前列腺上皮细胞增作用调节

目的：体外观转化生长因子－β1(TGF-β1）、表皮生长因子（EGF）对前列腺上皮细胞增殖的调节作用。方法：胶原酶消化组织,建立原代前列腺上皮细胞系,细胞培养于无血清培养基中。前列腺特异抗原（PSA）、Pan-Keratin等免疫组织化学染色鉴定培养细胞。给制细胞生长曲线和运用细胞增殖ELISA染色（BrdU)方法观察传代后细胞的生长状况及不同剂量的生长因子TGF-β1、EGF对细胞增殖的作用。结果：培养细胞具有典型的上皮细胞形态特征,PSA、Pan-Keratin染色阳性,细胞传代5－7次开始衰退。不同培养基条件可明显地影响细胞生长活性。EGF促进细胞增殖活性,TGF-β1则抑制增殖,其作用与剂量成正比。此外,EGF与TGF-β1相经减弱对方的作用。结论：体外培养的人前列腺上皮细胞增殖受生长因子TGF-β1和EGF调节,结果提示TGF-β1、EGF可能在前列腺增生（BPH）发病中起重要作用。     

糖皮质激素对老年鼻息肉患者表皮生长因子和表皮生长因子受体的表达影响及其临床作用

目的探讨糖皮质激素治疗老年鼻息肉患者的效果及其对息肉组织中表皮生长因子(EGF)和表皮生长因子受体(EGFR)表达水平的影响。方法纳入2014年1月至2016年8月在我院接受糖皮质激素治疗的60例老年鼻息肉患者(息肉组)及鼻中隔偏曲患者20例(对照组)。息肉组患者采用布地奈德喷剂治疗12周,分别于治疗前、治疗后采集息肉组织及对照组鼻黏膜组织进行免疫组化染色及逆转录-多聚酶链反应(RT-PCR)检查,对比两组EGF和EGFR蛋白及信使核糖核酸(mRNA)表达水平。计量资料以均数±标准差表示,两组间比较采用t检验。结果息肉组患者的鼻息肉病变评分情况:治疗前(2.48±0.77)分,治疗2周后(2.11±0.68)分,治疗6周后(1.57±0.49)分,治疗12周后(1.29±0.64)分;鼻息肉病变评分呈逐渐降低趋势,各时间点比较差异具有统计学意义(P0.05)。息肉组在治疗前、治疗后的EGF、EGFR蛋白表达水平和mRNA表达水平均高于对照组(P0.05);息肉组治疗12周后鼻息肉组织中EGF和EGFR蛋白表达水平和mRNA表达水平较治疗前均显著降低(P0.05)。结论糖皮质激素治疗老年鼻息肉患者的效果肯定,其作用机制与抑制鼻息肉组织中EGF及EGFR表达有关。     

表皮生长因子与肝癌

表皮生长子与肝癌的发生与发展有着密切的关系,对其作用机制的研究,可为肝癌的防治提供新的途径。     

高糖对人腹膜间皮细胞间粘合连接复合体的影响

目的 :研究高糖对人腹膜间皮细胞 (HPMC)间粘合连接复合体表达的影响 ,探讨腹膜透析 (PD)中腹膜间皮层完整性损伤的机制。　 方法 :采用人腹膜间皮细胞株HMrSV 5为研究对象。细胞分为 3组 :①正常对照组 (含 5 5mmol/LD 葡萄糖 ) ;②高糖组 (含 140mmol/LD 葡萄糖 ) ;③高渗组 (含 5 5mmol/LD 葡萄糖及 134 5mmol/L甘露醇 ) ,各组分别于 6、12、2 4、48h进行实验。采用半定量逆转录聚合酶链反应 (RT PCR)、Westernblot及免疫荧光等方法检测粘合连接复合体主要成分E Cadherin、β Catenin基因及蛋白水平表达 ,采用免疫荧光技术观察高糖对细胞Actin微丝骨架的影响。　 结果 :①高糖致细胞脱落呈时间依赖效应 ;②高糖引起E Cadherin、β CateninmRNA及蛋白表达下降 ,免疫荧光显示二者在HPMC细胞膜上的表达明显减低 ,呈不连续分布 ;③高糖使Actin微丝骨架解体 ;④高渗透压组未见上述效应。　 结论 :高糖使HPMCE Cadherin、β Catenin基因及蛋白表达下降 ,微丝骨架解体 ,从而损害细胞间粘合连接复合体的形成 ,造成腹膜间皮完整性的损害。     

Language of CTO interventions – Focus on hardware

The knowledge of variety of chronic total occlusion (CTO) hardware and the ability to use them represents the key to success of any CTO interventions. However, the multiplicity of CTO hardware and their physical character and the terminology used by experts create confusion in the mind of an average interventional cardiologist, particularly a beginner in this field. This knowledge is available but is scattered. We aim to classify and compare the currently used devices based on their properties focusing on how physical character of each device can be utilized in a specific situation, thus clarifying and simplifying the technical discourse.     

High prevalence of distal sensory polyneuropathy in antiretroviral-treated and untreated people with HIV in Tanzania

Objectives To describe the prevalence of distal sensory polyneuropathy (DSP), a complication of both advanced HIV disease and of antiretroviral therapy (ART), amongst Tanzanians with HIV, on and off ART (including stavudine) with CD4 counts above and below 200 cells/μl. Methods We recruited participants attending ART clinic into four groups: >6 months ART exposure and (i) CD4 < 200 cells/μl or (ii) CD4 > 200 cells/μl (ART/CD4 < 200 and ART/CD4 > 200, respectively); ART‐naïve and (iii) CD4 < 200 cells/μl or iv)CD4 > 200 cells/μl (noART/CD4 < 200 and noART/CD4 > 200, respectively). Primary outcome was DSP, as defined by presence of at least one symptom and one sign. Results Of 326 evaluable participants, 81 (32 men, median age 38 years, median CD4 142 cells/μl) were enrolled in the ART/CD4 < 200 group, 78 (17 men, median age 37 years, median CD4 345 cells/μl) in ART/CD4 > 200, 81 (30 men, median age 37 years, median CD4 128 cells/μl) in noART/CD4 < 200 and 86 (22 men, median age 33 years, median CD4 446 cells/μl) in noART/CD4 > 200. Numbness was the most commonly reported symptom. DSP prevalence ranged from 43.2% in ART/CD4 < 200 to 20.9% in noART/CD4 > 200. DSP was more common among men (adjusted odds ratio [aOR] 1.9, 95% confidence interval [CI] 1.2–3.3) and older participants (aOR 2.7, 95% CI 1.1–6.2 for age 40 + vs. <30 years). Conclusion Distal sensory polyneuropathy is common amongst those attending this clinic, even those with no ART exposure and a CD4 count above 200 cells/μl. Stavudine and didanosine expose HIV‐infected patients to an additional avoidable risk of DSP. Access to non‐neurotoxic ART regimes as well as earlier HIV diagnosis and initiation of ART is needed.     

Prise en charge d’un paragangliome rétropéritonéal

Paragangliomas are rare tumors arising from extraadrenal chromaffin cells. We report a 43-year-old man who presented with abdominal pain. An abdominal computed tomography scan revealed a large retroperitoneal mass. During an endoscopic biopsy of this tumor, the patient experienced marked hemodynamic fluctuations with tachycardia and high blood pressure, and an extraadrenal pheochromocytoma was suspected. Measurements of plasma and urinary catecholamines and urinary total metanephrines ruled in the diagnosis. Echocardiography disclosed acute myocardial dysfunction that returned to normal after surgical resection of the paraganglioma. This report also underlines the importance of the anesthetic preparation and monitoring around the surgical procedure and the need of a long-term follow-up to detect malignant paraganglioma in the absence of histological criteria of benign tumor.     

High circulating D-dimers are associated with ascites and hepatocellular carcinoma in liver cirrhosis

AIM： To measure plasma D-dimer levels in cirrhotic patients with and without ascites, assessing the effect of ascites resolution in D-dimer concentration. METHODS： Seventy consecutive cirrhotic patients （M = 44, F = 26, mean age 65 years, SD ± 13）, observed from October 2005 to March 2006 were enrolled. Circulating D-dimer levels were measured using a latex-enhanced, immunoturbidimetric test. In patients with ascites （n = 42） the test was repeated after ascites resolution. RESULTS： Ascites was present in 42 patients （group A） and absent in 28 （group B）. Group A patients had more advanced liver disease. Hepatocellular carcinoma （HCC） was diagnosed in 14 patients and was more frequent in group B. Above normal range D-dimers were found in 45/70 patients. High D-dimers were more frequent in group A than in group B （P = 0.001）. High D-dimers were associated with presence of HCC （P = 0.048） only in group B. After ascites resolution, obtained in all patients, mean D-dimer values decreased in those 34 patients with high basal levels （P = 0.007）, returning to normal in 17. CONCLUSION： In patients with liver cirrhosis, ascites and HCC are the main factors associated with increased fibrinolytic activity.     

Artériopathie et hétérogénéité artérielle

More and more clinical observations and trials support the concept of heterogeneity of atheroma according to the arterial bed. In a pilot study named “Étude Comparative des Lésions Athéromateuses” (ECLA), we have shown that carotid and femoral plaques possess different characteristics. Carotid arteries display increased lipid content compared to femoral arteries whereas femoral arteries are more prone to calcify and to develop osteoid metaplasia. These observations should lead the researcher and the clinician to look at the cellular and molecular mechanisms governing the heterogeneity of atheromas. At last, a better understanding of the characteristics of plaques should help us to determine plaque stability, to prevent cardiovascular events and to choose the best medical, endovascular or surgical option.     

Influence of colostomy onin vivo andin vitro permeability of the rat colon

PURPOSE: Barrier properties of an isolated colon loop and the remnant colon in continuity with the gastrointestinal tract after colostomy were studied in the rat. METHODS: The in vivo absorption after colonic loop administration of the marker fluorescein sodium was measured as the urinary recovery. The in vitro permeability was measured in Ussing diffusion chambers as the transmucosal passage of [¹⁴C]mannitol and of human serum albumin in the isolated and the nonexcluded colonic segments and was compared with the corresponding colonic regions from sham-operated rats at 1 to 14 days after operation. RESULTS: Body weight gain of the rats decreased and diarrhea appeared from day 2 after colostomy. Histologic examination showed mucosal atrophy with decreased villus height in the isolated colonic loop and an increased villus height in the nonexcluded colon segment. Absorption of fluorescein sodium in the isolated loop was increased at 8 and 14 days. Moreover, permeability in the isolated loop was increased for both mannitol and human serum albumin from four days after colostomy compared with the corresponding colonic segments after the sham operation, whereas a decrease in the passage of mannitol was noted in the nonexcluded colon. CONCLUSIONS: Experimentally performed colostomy diversion in the rat induced alterations of the barrier function in both the isolated colonic loop and the nonexcluded colon in continuity with the fecal stream.The present study was done at the Department of Animal Physiology and supported by grants from the Medical Faculty, Lund University, the Swedish Medical Research Council (grant B 96-17X11616-01A), and the Swedish Natural Science Research Council.