Monocytes augment inflammatory responses in human aortic valve interstitial cells via β2-integrin/ICAM-1-mediated signaling

Objective

Inflammatory infiltration in aortic valves promotes calcific aortic valve disease (CAVD) progression. While soluble extracellular matrix (ECM) proteins induce inflammatory responses in aortic valve interstitial cells (AVICs), the impact of monocytes on AVIC inflammatory responses is unknown. We tested the hypothesis that monocytes enhance AVIC inflammatory responses to soluble ECM protein in this study.

Methods

Human AVICs isolated from normal aortic valves were cocultured with monocytes and stimulated with soluble ECM protein (matrilin-2). ICAM-1 and IL-6 productions were assessed. YAP and NF-κB phosphorylation were analyzed. Recombinant CD18, neutralizing antibodies against β₂-integrin or ICAM-1, and inhibitor of YAP or NF-κB were applied.

Results

AVIC expression of ICAM-1 and IL-6 was markedly enhanced by the presence of monocytes, although matrilin-2 did not affect monocyte production of ICAM-1 or IL-6. Matrilin-2 up-regulated the expression of monocyte β₂-integrin and AVIC ICAM-1, leading to monocyte-AVIC adhesion. Neutralizing β₂-integrin or ICAM-1 in coculture suppressed monocyte adhesion to AVICs and the expression of ICAM-1 and IL-6. Recombinant CD18 enhanced the matrilin-2-induced ICAM-1 and IL-6 expression in AVIC monoculture. Further, stimulation of coculture with matrilin-2 induced greater YAP and NF-κB phosphorylation. Inhibiting either YAP or NF-κB markedly suppressed the inflammatory response to matrilin-2 in coculture.

Conclusion

Monocyte β₂-integrin interacts with AVIC ICAM-1 to augment AVIC inflammatory responses to soluble matrilin-2 through enhancing the activation of YAP and NF-κB signaling pathways. Infiltrated monocytes may promote valvular inflammation through cell–cell interaction with AVICs to enhance their sensitivity to damage-associated molecular patterns.

     

护理本科应用型创新人才培养评价体系中的要素

论述了护理学应用型创新人才培养模式下的创新评价体系;除了从一元评价到多元评价,量化评价与质性评价结合及评价者和评价对象相结合之外,还要引入市场要素。并对培养应用型创新人才的市场要素作了较深入的分析,对护理学专业应用型创新人才培养具有指导意义。     

Creating magnetic ionic liquid-molecularly imprinted polymers for selective extraction of lysozyme

A novel magnetic (Fe₃O₄) surface molecularly imprinted polymer (MIP) based on ionic liquid (IL) (Fe₃O₄@VTEO@IL-MIPs) was prepared for the selective extraction of lysozyme (Lys). As the functional monomer of the MIPs, an imidazolium-based IL with vinyl groups was prepared. It can provide multiple interactions with template molecules. The amount of IL was optimized (200 mg). Fourier transform infrared spectrometry (FT-IR), transmission electron microscopy (TEM), dynamic light scattering (DLS), thermogravimetric analysis (TGA) and a vibrating sample magnetometer (VSM) were used to characterize the MIP. The results indicate the successful formation of an imprinting polymer layer. The concentration of Lys in the supernatant was determined by UV-vis spectrophotometry at a wavelength of 280 nm. The maximum adsorption capability of the MIP is 213.7 mg g⁻¹ and the imprinting factor (IF) is 2.02. It took 2.5 h for the MIP to attain adsorption equilibrium. The structure of the protein was evaluated using circular dichroism (CD) spectra and UV-visible spectra. The adsorption performance was further investigated in detail by selective adsorption experiments, competitive rebinding tests, and reusability and stability experiments. Furthermore, it was utilized to separate the template protein from a mixture of proteins and real samples successfully because of the high adsorption capacity for Lys.

A novel magnetic (Fe₃O₄) surface molecularly imprinted polymer (MIP) based on ionic liquid (IL) (Fe₃O₄@VTEO@IL-MIPs) was prepared for the selective extraction of lysozyme (Lys).     

社区护理人才培养模式的构建

目的培养适应我国卫生改革与发展需要的社区卫生服务护理人才。方法运用实验对比研究法,对实验班采用教学改革新模式,对照班按传统方式进行全程教学。经过三年的实施,对教学改革效果进行评价。结果根据社会需求构建社区卫生服务护理人才四三培养模式,该模式以“三个结合”为指导思想;以知识、能力、素质“三位一体”为核心;以实施预防战略思想全程教学、以问题为基础教学、社区实习教学“三个模块”为教学改革主线;以教学大纲、实习基地、评价体系“三个建设”为教学改革基础。对学生进行知识、能力、素质综合测试,表明实验班与对照班成绩差异有极显著意义。结论四三培养模式根据社区卫生服务需要设立护理人才培养目标,建立起融传授知识、培养能力及提高素质为一体的护理人才培养模式。     

内皮细胞微粒与糖尿病心肌病

内皮细胞激活、损伤、凋亡时,会向细胞外释放内皮微粒,其作为反映内皮细胞功能的新型标记物,在多种病理状态时都有增加。糖尿病心肌病的病理过程中,内皮损伤、血管再生、氧化应激与炎症反应以及肾素血管紧张素系统激活等过程都与内皮微粒存在紧密联系。     

脂质蓄积指数、内脏脂肪指数对2型糖尿病患者一级亲属糖代谢的影响

目的 探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者一级亲属中T2DM及葡萄糖调节受损(impaired glucose regulation,IGR)患者脂质蓄积指数(lipid accumulation product, LAP)、内脏脂肪指数(visceral fat index, VAI)的特征。方法 选取T2DM确诊患者(n=212)一级亲属共298例,依据葡萄糖代谢情况,将研究对象分为葡萄糖代谢正常(normal glucose tolerance,NGT)组(n=115)、IGR组(n=93)、T2DM组(n=90),并收集其临床资料。结果 3组性别差异无统计学意义(P>0.05),3组年龄、身高、体重、体质量指数、腰围差异均有统计学意义(P<0.05),NGT组年龄最小,T2DM组体重、腰围最大(均P<0.05)。NGT组、IGR组、T2DM组中心性肥胖发生率分别为52.17%、67.74%和78.88%,其中T2DM组肥胖率最高,T2DM组、IGR组的中心性肥胖率较NGT组高(均P<0.05)。3组LAP、VAI差异均有统计学意义(P<0.05),T2DM组LAP最高,NGT组VAI最高(均P<0.05)。LAP、VAI是T2DM患者患有T2DM一级亲属糖化血红蛋白的独立影响因素,LAP是T2DM患者患有IGR一级亲属口服葡萄糖耐量试验2 h血糖的独立影响因素。结论 T2DM患者一级亲属中糖尿病及糖尿病前期患者的中心性肥胖率明显增加,其中新型体脂指标LAP、VAI是T2DM患者一级亲属葡萄糖代谢紊乱的重要影响因子。     

股骨头坏死的临床与影像诊断

目的　探讨股骨头缺血坏死的临床表现 ,X线平片、CT、MRI和DSA表现 ,以提高该病的确诊率。方法　对 116例共计 184髋股骨头坏死 ,采用X线平片及CT联合检查 ,并通过MRI或 /和DSA检查证实 ,总结各期的临床表现与影像学改变。结果　按Ficat分期标准 ,Ⅰ期 18髋 ,Ⅱ期 10 1髋 ,Ⅲ期 44髋 ,Ⅳ期 2 1髋。其中X线平片阳性 94髋 ,全部为Ⅱ期以上 ,CT阳性 115髋 ,Ⅰ期仅占 3髋 ,MRI阳性 161髋 ,Ⅰ期 12例。行DSA检查 68例 ,主要表现为股骨头供养动脉的变细、缺失。结论　因股骨头坏死缺乏特征性临床表现 ,其诊断一直为临床上的一个难题 ,MRI和DSA对股骨头坏死的诊断具有高度敏感性 ,因此X线平片和CT结果阴性者 ,必须做MRI或 /和DSA检查 ,以免漏诊     

关节镜下自体四股腘绳肌腱可吸收界面螺钉重建前交叉韧带

目的探讨自体四股绳肌腱、可吸收界面螺钉重建前交叉韧带(anteriorcruciateligament,ACL)的手术方法及疗效。方法关节镜下以自体四股绳肌腱为ACL重建替代物,保留少许ACL残端作为定位标志物,应用可吸收界面螺钉固定,对37例ACL损伤病例行重建术。结果随访6～28个月,平均11.4个月。术后36例膝关节活动度在正常范围,无韧带撞击现象。Lachman试验:33例≤1 ,4例2 。轴移试验术后全部阴性。Lysholm评分由术前的平均50.1分提高到术后的平均90.5分,差异有显著性意义(P<0.05)。结论关节镜下自体四股绳肌腱、可吸收界面螺钉重建ACL是恢复膝关节稳定性较好的方法。准确的关节内入口定位是手术成功的关键。     

胸膜腔造影和注射粘连剂对难治性气胸的诊治

目的：为更清晰地显示顽固性气胸的漏气部位和性质，为不能耐受手术者摸索一种新的治疗手段。方法：选择１８例患者，先用７６％泛影葡胺行胸膜腔造影，而后在局部注入少量粘连剂。结果：造影后发现多发性肺大泡８例，单发性肺大泡６例，肺大泡伴粘连带４例。病变分别位于左上肺，右上肺，中下肺野及叶间裂。注射粘连剂后，１５例一次成功，３例第二次成功。随防６～１８个月，未见复发。结论：该方法易掌握，无明显副作用。病变显示明显，易被患者接受，具有明显的临床效果和推广价值     

早期电针干预对急性脑梗死患者炎性因子的影响

目的：观察在发病48 h 内电针头穴和体穴对急性脑梗死（ACI） 患者神经功能及炎性因子的影 响。方法：选取60 例ACI 患者,发病时间均在48 h 时内,随机分成对照组和电针组,每组30 例。2 组均予 以常规内科治疗,对照组给予规范康复治疗,电针组在对照组治疗方案的基础上给予电针头穴和体穴治疗,均 治疗14 d。治疗前后,比较2 组临床疗效并观察神经功能和血清肿瘤坏死因子-α （TNF-α）、白细胞介 素-10 （IL-10）、白细胞介素-17 （IL-17） 的变化情况,并比较其相关性。比较治疗前后及治疗结束3 个月 后,2 组美国国立卫生研究院卒中量表评分（NIHSS） 和生活自理能力（Barthel） 评分,观察治疗的短期及远 期疗效。结果：治疗后,2 组NIHSS 评分、Barthel 评分和血清TNF-α、IL-10、IL-17 均改善（P＜0.05）,且 电针组NIHSS 评分和血清TNF-α、IL-17 低于对照组,Barthel 评分和血清IL-10 高于对照组（P＜0.05）。 NIHSS 评分与血清TNF-α、IL-17 呈正相关,与IL-10 呈负相关（P＜0.05）。电针组临床疗效总有效率高于对 照组（P＜0.05）。治疗结束3 个月后,2 组组间比较,NIHSS 评分和Barthel 指数有改善（P＜0.05）。结论：常 规药物配合康复治疗能够明显改善ACI 患者神经功能缺损情况,提高日常生活能力,促进肢体运动功能恢 复。在此基础上,于发病后48 h 内给予电针头穴和体穴治疗可以加强上述疗效,并有较好的远期效果,其作 用机制可能与调节TNF-α、IL-10、IL-17 等炎性因子表达、减轻脑组织炎性损伤有关。