Isolated unilateral absence of a pulmonary artery: influence of systemic circulation on alveolar capillary vessels

We report a case of isolated unilateral absence of a pulmonary artery. The first clinical symptom that was manifested in the patient was recurrent hemoptysis, and subsequent angiography revealed that the main pulmonary artery was absent in the right lung, which was being fed only from the systemic circulation. Right pneumonectomy was performed, and neither the main pulmonary artery nor its remnant was detected in the resected right lung. Histologically, there were many muscular vessels in the resected lung, with intimal proliferation, or with plexiform-like lesions. The alveolar septum was moderately thickened and alveolar capillary vessels were dilated. We examined the alveolar capillary endothelial cells of the resected lung for immunoreactivity to thrombomodulin (TM) and von Willebrand factor (vWF). The endothelial cells were negative for TM and positive for vWF, while in the normal lung control group, these cells were positive for TM and negative for vWF. We considered that the hemodynamics of the systemic circulation in the resected lung caused the alteration of immunohistochemical characteristics in alveolar capillary endothelial cells.     

弯曲血管内血流与动脉粥样硬化斑块的相互影响与作用

作为文章[1]的继续,本文在文章[1]的分析结果基础上,针对壁面对称和非对称狭窄的两种不同情况,通过数值计算给出弯曲狭窄血管内血流的轴向和周向切应力的分布曲线,并讨论其随管壁面几何参数的变化情况。同时,还讨论壁面几何参数对平均血流量和压力降影响的规律。从中发现,当狭窄较轻时(λ<0.2),壁面切应力、平均流量和压力降受狭窄度(λ)的影响不大,而在狭窄较严重时(λ>0.7),狭窄度微小的变化会引起它们急剧变化。此外,在讨论狭窄的非对称性对上述血流动力学参数的影响时还发现,非对称性只对轴向切应力有明显的影响,而对其它参量的影响并不十分显著。     

超声彩色脉搏波技术在定量评价2型糖尿病患者颈动脉弹性变化中的应用

目的 探讨超声彩色脉搏波(UFPWV)技术在定量评价2型糖尿病患者颈动脉血管管壁弹性变化中的应用价值。方法 回顾性研究。纳入2018年7月-2019年3月蚌埠医学院第一附属医院收治的97例2型糖尿病患者为观察组,其中男47例、女50例,年龄20~74(46.6±9.3)岁;根据颈动脉内中膜厚度(IMT)将观察组分为颈动脉粥样斑块组(A组)、颈动脉内中膜增厚组(B组)和颈动脉内中膜正常组(C组),依据下肢动脉有无斑块将C组分为下肢动脉斑块组(C1组)、下肢动脉无斑块组(C2组)。选取2017年12月-2018年12月在蚌埠医学院第一附属医院体检中心血糖及颈动脉IMT正常的健康体检者64人为对照组,其中男25人、女39人,年龄20~74(44.3±12.0)岁。运用UFPWV采集脉搏波速度 (PWV),计算颈动脉收缩早期PWV(PWV-BS)及收缩晚期PWV(PWV-ES),分析各项参数组间的差异。结果 观察组中,A组颈动脉PWV-BS、PWV-ES分别为(9.51±1.25)m/s、(10.79±1.64)m/s,B组分别为(8.47±0.91)m/s、(9.81±1.05)m/s,C组分别为(7.97±0.77)m/s、(9.07±0.74)m/s,对照组颈动脉PWV-BS、PWV-ES分别为(6.10±1.00)m/s、(7.40±1.20)m/s,A组、B组、C组及对照组间颈动脉PWV-BS、PWV-ES测量值依次降低,差异均有统计学意义(P值均<0.05)。C组中,C1组颈动脉PWV-BS、PWV-ES分别为(7.83±0.85)m/s、(8.82±0.59)m/s,C2组分别为(8.14±0.64)m/s、(9.34±0.79)m/s, C1组PWV-ES显著高于C2组,差异有统计学意义(t=3.402,P＜0.01),而两组间PWV-BS的差异无统计学意义(P>0.05)。结论 UFPWV技术可定量评价2型糖尿病患者颈动脉弹性变化,并可通过PWV-ES的改变评估颈动脉形态学正常的患者动脉粥样硬化的进展程度,对临床诊疗具有一定意义。     

Control of fluid shear response in circulating leukocytes by integrins

Recent evidence shows that circulating leukocytes respond not only to humoral inflammatory mediators but also to fluid stresses. Application of fluid shear stress (of the order of 1–10 cm² to fresh migrating leukocytes leads to initial retraction of pseudopods, an important step to facilitate normal passage of leukocytes through the microcirculation and to prevent spreading on the endothelium. The ability to respond to fluid shear stress, however, may be regulated under different physiological conditions. In the current study, we examine the role of integrins in the fluid shear response as measured by pseudopod retraction with the use of antibodies against human neutrophil ₁ and ₂ integrins. Neutrophils adhering via ₂ integrins exhibit normal ability to project pseudopods and to migrate. Such cells show normal response to fluid shear with rapid pseudopod retraction. In contrast, attachment via ₁ integrins leads to firmly adhesive leukocytes, spreading and almost no cell migration. Such leukocytes exhibit a significantly attenuated ability for pseudopod retraction under fluid shear. These results suggest that integrins may serve as a regulating mechanism for fluid shear response in human leukocytes. Attachment via ₁ integrins may lead to an abolishment of the fluid shear response. © 2002 Biomedical Engineering Society. PAC2002: 8716-b, 8719Tt     

具有梯度的流体切应力促进血管内皮细胞增殖

目的探讨流体切应力(shear stress,SS)对血管内支架边缘内皮细胞(endothelial cells,ECs)增殖的影响。方法应用具有切应力梯度的平行平板流动腔(梯度切应力组)和普通矩形平行平板流动腔(恒定切应力组),分别对ECs施加0.566￣1.438Pa和1.137Pa的切应力,加载时间6h,以未施加切应力的ECs为静止对照组。流式细胞仪检测各组ECs细胞周期的变化。结果梯度切应力组ECs在受力6h后进入S期与G2+M期细胞明显多于静止对照组与稳定切应力组(P<0.05);恒定切应力组的ECs受力后进入S期与G2+M期细胞明显少于其他两组(P<0.05)。结论梯度切应力促进ECs进入分裂增殖期,而稳定的层流切应力则产生对ECs细胞周期的抑制作用。提示血管内支架植入后,继发的血流切应力改变诱导细胞进入分裂、增殖期,这可能是引起支架内再狭窄过程中血管内膜增生的原因之一。     

ERK1/2信号转导途径在低切应力上调人脐静脉内皮细胞IL-8基因表达中的作用

血管内皮细胞位于血流和血管壁之间,除受化学因素的调节外还受力学因素的影响。切应力可通过刺激相应的力学感受系统来调节内皮细胞某些基因的表达,其中包括诱导内皮细胞表达IL- 8。为了阐明MAPK信号途径中的ERK1/ 2信号通路是否参与调控低切应力上调人脐静脉内皮细胞IL- 8基因表达,采用Western blot分析了低切应力(4.2 0 dyne/ cm2 )处理不同时间内皮细胞ERK1/ 2的磷酸化水平及TPK抑制剂Genistein,MEK抑制剂PD980 5 9对其磷酸化的影响;采用定量RT- PCR检测内皮细胞经低切应力刺激或给予阻断剂后再行切应力刺激等处理后IL- 8基因的表达。结果显示:(1)低切应力处理可引起内皮细胞ERK1/ 2蛋白磷酸化水平上调,其磷酸化水平与切应力作用时间有关,具有快速、双向性的特点(在刺激10 min时达到高峰,2 h左右降至未刺激水平) ,阻断剂Genistein和PD980 5 9处理后,ERK1/ 2磷酸化水平与低切应力刺激10 min比较明显降低;(2 )阻断剂Genistein,PD980 5 9可显著抑制低切应力所致的内皮细胞IL- 8m RNA上调。结果表明低切应力可通过ERK1/ 2信号途径上调人脐静脉内皮细胞IL- 8基因的表达。     

Endothelial Regulation of Vascular Repair: Role of bFGF in Paracrine Pathways

Vascular repair following injury is mediated by both endothelial and smooth muscle cells often through paracrine pathways. Basic fibroblast growth factor (bFGF) is present at sites of vascular injury. The role of bFGF in regulating reendothelialization through an effect on centrosome redistribution in cell migration is discussed. The role of bFGF in neointimal formation, especially as it relates to smooth muscle cell proliferation, is reviewed. It is concluded that bFGF appears to be an important agent regulating the early responses of the artery wall to injury. Presented in part at the Molecular Endocrine Pathology Symposium at the International Academy of Pathology XXI International Congress, Budapest, Hungary, October 20–25, 1996.     

一种平板流动腔重力灌流系统的力学分析

本文分析了一种采用重力灌流的平板流动腔灌流系统，并根据实验结果确定出相应的阻力系数，获得平板流动腔剪应力、雷诺数以及入口长度与流体重力灌流高度的关系。     

钛颗粒负荷对切应力作用下骨髓间质干细胞F-actin表达和DNA含量的影响

假体磨损碎屑颗粒是引起假体一骨界面无菌性炎症和骨溶解而致全关节置换术失败的主要原因之一。磨屑颗粒所诱发的骨溶解须有周围骨组织中成骨细胞分泌足够的骨基质以弥补丢失的骨量，而成骨细胞正常的数量和质量有赖于其来源骨髓祖细胞—骨髓问质干细胞的正常增殖分化能力的维持。为了探讨磨屑钛颗粒对大鼠骨髓间质干细胞(Rat MSCs，rMSCs)产生细胞毒性的可能细胞分子机制，选用健康3月龄SD雄性大鼠，采用Percoll等密度梯度离心法分离获取rMSCs，经体外传代纯化培养后，与不同直径、不同负荷浓度、不同负荷作用时间的钛颗粒悬液共孵育，再采用精准的流室系统对钛颗粒负荷的rMSCs施加一定的流体剪切应力(Fluid shear stress，FSS)后立刻固定细胞，经免疫荧光抗体染色，结合激光共聚焦显微镜技术和图像分析软件定性定量分析rMSCs F—actin表达和DNA含量的变化情况。同时设置相应的未经钛颗粒孵育的rMSCs细胞为对照组细胞。结果显示，切应力作用可上调rMSCs胞内F—actin的表达。亚微(Submieron)直径(0．9μm)的钛颗粒负荷对rMSCs F—actin表达和DNA含量的抑制作用最为显著，并伴有凋亡小体出现；直径为2．7μm的钛颗粒负荷产生的抑制作用略为减弱，而较大直径(6．9μm)的抑制效应最弱。相同条件下，钛颗粒负荷对F—actin的抑制效应有一定的时间和浓度依赖性：以0．1wt％浓度对F—actin表达和DNA含量的抑制效应最为明显，亦有凋亡小体的出现；随着浓度的降低，抑制作用亦减弱，以0．01wt％浓度最弱；随着作用时间的延长，F—actin表达和DNA含量逐渐降低，至实验中的32h达到最低值。提示：磨屑颗粒对rMSCs活力的抑制作用是假体无菌性松动的可能分子机制，对其具体细胞分子机制进行深入研究，必将有助于有效防治假体松动药物的研发应用以及人工关节材料的优化设计，从而为全关节置换术患者真正带来福音。     

U波倒置40例临床分析

U波倒置40例,其中孤立性U倒16例(40％),复合性U倒24例(60％)。U波倒置常见于左心前导联V_5V_6,呈现左室肥厚及负荷加重,心电图示“左室劳损”型。U波倒置严重合并症,除心力衰竭外,还有急性心肌梗塞和室性期前收缩。笔者认为,通过本文分析,UV_5倒置对临床诊断冠心病,高血压等是有价值的。