间歇性低氧大鼠肺内TLR4的表达及影响

目的 通过慢性歇性低氧造成大鼠阻塞性睡眠呼吸暂停(OSA)的模型,检测TLR4在肺内的表达,探讨TLR4的表达水平对肺部炎症及其他可能发生的病变的影响。方法 将SPF级健康雄性Wistar大鼠32只采用数字表法随机分为4组(每组8只),分别为A组(常氧组)、B组(轻度低氧组,即氧浓度为15%)、C组(中度低氧组,即氧浓度为9%)和D组(重度低氧组,即氧浓度为6%)。造模35天后,取肺组织于光镜下观察大鼠肺组织形态学变化,免疫组化检测TLR4在各组大鼠肺组织中的表达水平。结果 A组肺组织未见明显异常,B、C、D这3组肺泡间隔增厚,淋巴细胞浸润,部分伴有肺气肿改变,随缺氧程度增加肺泡破坏程度加重。免疫组化结果显示,A组中无TLR4表达,B、C、D这3组TLR4呈梯度表达,D组TLR4表达最明显,差异有统计学意义(P=0.000)。结论 慢性间歇性低氧可以造成大鼠肺组织的病理损伤和炎症,且随着缺氧程度的增加,肺组织的病理损伤更严重,TLR4表达更多。     

间歇性低氧动物模型的建立及验证

目的研制间歇性低氧(intermittent hypoxia,IH)氧舱,建立IH动物模型并进行验证,为深入开展阻塞性睡眠呼吸暂停低通气综合征(OSAHS)机制的研究提供实验平台。方法采用隔离密封的结构和电气控制技术,研制均匀混合各种气体浓度的氧舱,调整实验参数,建立3个IH大鼠模型:90s 10%模型组(A组)、60s 10%模型组(B组)、60s 5%模型组(C组)同时加入空气模拟对照组(D组),实验利用A、B、C、D 4组大鼠,造模前后测量体温和呼吸次数,造模后2h行血气分析,记录5个时间点的PO2(P1、P2、P3、P4、P5)和SaO2(S1、S2、S3、S4、S5),分析结果并对3个模型进行评价。结果模型组造模后呼吸较造模前加快(P<0.05),体温无明显变化。在一个低氧-复氧周期内,同一模型组的PO2、SaO2有明显波动,S3及P3与其他时间点的PO2、SaO2比较明显下降(P<0.05)。与D组比较,各模型组P3及S3降低(P<0.05);与A组比较,B组P3及S3升高(P<0.05),C组P3及S3降低(P<0.05)。结论本IH氧舱模型操作简便、控制精确、重复性佳,60s 10%、90s 10%、60s 5%模式分别模拟轻度、中重度、重度OSAHS,符合疾病的病理生理特点,是研究OSAHS睡眠呼吸暂停—慢性间歇低氧模式的理想动物模型。     

不同病程系统性红斑狼疮患者血清PGRN、FSTL1水平及临床意义

目的研究不同病程系统性红斑狼疮(SLE)患者血清颗粒蛋白前体(PGRN)、卵泡抑素样蛋白1(FSTL1)水平及临床意义。方法选取2015年6月至2018年7月南阳市第二人民医院收治的58例SLE患者作为观察组,其中SLE活动期30例,稳定期28例,另选取同期60例健康体检者作为对照组,比较两组血清FSTL1、PGRN水平。结果观察组患者血清FSTL1、PGRN水平与对照组比较,差异有统计学意义(均P<0.05);SLE活动期患者血清FSTL1、PGRN水平均高于SLE稳定期患者和对照组,差异有统计学意义(均P<0.05);SLE稳定期患者血清FSTL1、PGRN水平均高于对照组,差异有统计学意义(均P<0.05)。结论血清FSTL1、PGRN在SLE患者中呈异常升高状态,且随SLE患者病程严重程度呈逐渐上升趋势,可作为SLE疾病活动的有效参考指标,有助于判断病情程度,为临床制定治疗方案、评估疗效及预后提供有力信息支持。     

睡眠呼吸暂停综合征对肝脏的损伤

阻塞性睡眠呼吸暂停综合征（OSAS）是一种具有潜在危险的常见疾病,在睡眠呼吸疾病中发病率最高,其特征是在夜间睡眠过程中反复出现上气道阻塞而导致间断发生的夜间觉醒及血氧饱和度下降。随着OSAS严重程度增加,血清丙氨酸氨基转移酶及乳酸脱氢酶升高;提示OSAS可能通过间断缺氧途径导致肝功能损伤,引起非酒精性脂肪性肝病（NAFLD）。肝脏损伤的严重程度与OSAS的低氧负荷程度成正比。     

慢性间歇低氧对大鼠肝fractalkine表达的影响

目的：利用大鼠模型观察慢性间歇低氧（chronic intermittenthypoxia,CIH）对肝的损伤以及对肝趋化因子fractalkine表达的影响,并探讨其可能的机制。方法：利用间歇低氧大鼠模型模拟阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hypopnea syndrome,OSAHS）的CIH的病理生理过程。30只雄性Spraque—Dawley大鼠随机分为5％慢性间歇低氧组、s％慢性间歇低氧复氧组和正常对照组,每组10只。5％慢性间歇低氧组给予间歇性低氧处理3周,低氧频率均为20次／h,每次循环180s,8h／d;s％慢性间歇低氧复氧组给予间歇性低氧处理3周,低氧频率均为20次／h,每次循环180s,8h／d,3周后继续正常气体环境饲养3周。处死大鼠后采用HE染色法观察各组大鼠肝组织病理改变,免疫组织化学法比较各组大鼠肝fractalkine的表达水平。结果：1）与正常对照组相比,5％慢性间歇低氧组和5％慢性间歇低氧复氧组大鼠肝脂肪变程度及炎症反应均增加（均P〈0．01）;s％慢性间歇低氧复氧组大鼠肝损伤较5％慢性间歇低氧组显著减轻（P〈0．01）。2）与正常对照组相比,5％慢性间歇低氧组和5％慢性间歇低氧复氧组大鼠肝组织fractalkine表达均显著增强（均P〈O．01）;5％慢性间歇低氧复氧组较5％慢性间歇低氧组显著减弱（P〈0．01）。结论：CIH可诱导大鼠肝组织损伤及大鼠肝组织趋化因子fractalkine表达增加。     

慢性间歇低氧对大鼠肝CXC趋化因子配体10表达的影响及抗氧化剂的干预作用

目的：通过大鼠模型观察慢性间歇低氧(chronic intermittent hypoxia,CIH)对肝的损伤及其对肝CXC趋化因子配体10(CXC chemokine ligand-10,CXCL10)表达的影响,并探讨N-乙酰半胱氨酸(N-acetylcysteine,NAC)干预作用及机制。方法：21只健康雄性Spraque-Dawley大鼠随机分为正常对照组、慢性间歇低氧组(CIH组)和慢性间歇低氧+N-乙酰半胱氨酸组(CIH+NAC组),每组7只。对照组置于空气循环舱内,其余两组置于间歇低氧舱内,每日8 h,共5周;对照组及CIH组每日均给予生理盐水灌胃,CIH+NAC组每日给予NAC溶液灌胃。5周后处死大鼠,测定大鼠肝组织MDA含量和SOD活力,采用HE染色法观察各组大鼠肝组织病理改变,免疫组织化学法比较各组大鼠肝CXCL10的表达水平。结果：与对照组相比,CIH组、CIH+NAC组大鼠肝MDA水平均升高(均P<0.05),SOD活力均降低(均P<0.05);与CIH组比较,CIH+NAC组大鼠肝MDA降低,SOD活力升高,差异均有统计学意义(均P<0.05)。与对照组比较,CIH组和CIH+NAC组大鼠肝脂肪变程度及炎症反应均增加(均P<0.01);CIH+NAC组大鼠肝损伤较CIH组减轻(P<0.05)。与对照组相比较,CIH组和CIH+NAC组大鼠肝组织CXCL10表达均增强(均P<0.01);CIH+NAC组较CIH组减弱(P<0.01)。结论：CIH可导致大鼠肝组织损伤,并使大鼠肝组织CXCL10表达增加;NAC可以减轻CIH导致的大鼠肝氧化应激和炎症反应,部分改善大鼠肝损伤。     

阻塞性睡眠呼吸暂停综合征夜间低氧血症与心律失常的关系

阻塞性睡眠呼吸暂停综合征 (ＯＳＡＳ)是一种睡眠期疾病 ,由于反复发生低氧血症和睡眠结构紊乱 ,临床上常引起心律失常、心力衰竭、心绞痛、心肌梗死 ,也是冠心病、高血压的独立危险因素。关于ＯＳＡＳ患者夜间低氧血症与室性心律失常及心律变化的影响 ,国外进行了一些研究。我们对ＯＳＡＳ患者夜间低氧血症与室性心律失常发生及呼吸暂停后心率变化的关系进行探讨 ,分析夜间低氧血症对室性心律失常和心率变化的影响 ,为预防ＯＳＡＳ心血管并发症的发生提供依据。1　对象与方法1 1　研究对象　选择门诊和住院疑诊为ＯＳＡＳ的病人 ,行多导睡…     

牛磺熊去氧胆酸钠抑制小鼠间歇性低氧模型肺组织中内质网应激的激活

目的：探究牛磺熊去氧胆酸钠(tauroursodeoxycholic acid sodium,TUDCA)在间歇性低氧(intermittent hypoxia,IH)模型小鼠肺组织中抑制细胞凋亡的机制。方法：32只C57小鼠随机分为对照组、TUDCA组、IH组和IH+TUDCA组,每组8只。将C57小鼠放入低氧舱中进行IH处理4周 (氧气浓度从21%下降到10%,再从10%恢复到21%为一个循环,每个循环的时间为90s),每天持续8h。4周IH处理后,Western印迹检测caspase-12和cleaved caspase-3在肺组织中的表达。同时,Western印迹、免疫组织化学和实时定量PCR检测葡萄糖调节蛋白78(glucose regulated protein 78,GRP78) 和CCAAT/增强结合蛋白同源蛋白(CCAAT/enhancer-binding protein homologous protein,CHOP)的表达。结果：与对照组和TUDCA组相比,IH组小鼠肺组织中caspase-12,cleaved caspase-3,GRP78和CHOP表达明显升高(均P<0.01);而在IH+TUDCA组中,TUDCA能够显著地减少上述蛋白的表达(均P<0.05)。结论：慢性的IH能够导致肺组织中内质网应激介导的细胞凋亡,而TUDCA可以通过抑制内质网应激的激活来降低细胞的凋亡水平。     

间歇性低氧大鼠氧化应激状态与胰岛素抵抗的相关实验研究及吡格列酮干预作用

目的：探讨吡格列酮对间歇性低氧大鼠氧化应激与胰岛素抵抗的干预作用。方法：建立OS-AHS模型,将SD雄性大鼠36只随机分为常氧对照组、模型组、吡格列酮干预组,每组12只。干预组给予吡格列酮10ml·kg-1·d-1灌胃,模型、对照组均予等量生理盐水灌胃。于实验8周终点处死大鼠,硫代巴比妥酸法、酶联免疫吸附法、比色法、蛋白免疫印迹等方法观察各组大鼠血清TNF-α、MDA、GsH-Px、H（JMA-IR及胰腺组织NF-KB蛋白的表达情况。结果：与对照组比较,模型、干预组大鼠血清TNF-α、MDA、FBG、FlNS、HOMA-IR及胰腺组织NF-KB蛋白表达均升高,GSH-Px水平降低（P〈O．05）;与模型组比较,干预组血清TNF-α、MDA、FBG、FINS、HOMA-IR及胰腺组织NF-KB蛋白表达均降低,GSH-Px水平升高（P〈0．05）。结论：吡格列酮可通过抑制NF-κB核转位降低慢性间歇行低氧氧化应激水平,改善胰岛素抵抗状态。     

慢性间歇性低氧对大鼠胸主动脉内皮细胞的影响

目的 探讨慢性间歇性低氧对大鼠胸主动脉内皮细胞的损伤变化。方法 将12只10～12周龄的雄性SD大鼠采用抽签法分为对照组和实验组,每组各6只。实验组大鼠每天10点至18点置于间歇性低氧环境中暴露,对照组大鼠不做低氧处理,共4周。饲养时间结束后取大鼠胸主动脉标本行苏木精-伊红染色（hematoxylin and eosin staining,HE染色）及原位末端转移酶标记法（terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay,TUNEL）染色观察细胞病变情况,并计算病变细胞、凋亡细胞在视野中所占比例。结果 HE染色光镜下实验组可见血管内皮细胞肥大,排列不规则,细胞核、胞质着色淡,平滑肌细胞核肿胀;对照组见血管内皮细胞和平滑肌细胞排列规则、细胞核形态及染色正常。TUNEL染色光镜下实验组可见多个凋亡细胞,对照组偶见凋亡细胞。实验组大鼠主动脉组织的细胞病变率及凋亡率均显著高于对照组（P<0.01）。结论 阻塞性睡眠呼吸暂停低通气综合征所产生的慢性间歇性低氧可损伤大鼠胸主动脉...     

卵泡抑素样蛋白1促进肺动脉内皮细胞增生、黏附与血管生成

目的 探究卵泡抑素样蛋白1（follistatin-like 1,FSTL1）对人肺动脉内皮细胞（human pulmonary artery endothelial cells,HPAECs）的影响,完善FSTL1在肺动脉高压（pulmonary hypertension,PH）中的作用。方法 以人肺动脉内皮细胞为对象,使用qRT-PCR和Western blotting法测定低氧刺激下HPAECs中FSTL1的表达水平。通过给予外源性FSTL1蛋白或小干扰RNA,MTT法观察FSTL1对细胞增生活性的影响。分别借助纤连蛋白、Matrigel基质胶观察FSTL1对内皮细胞黏附与血管形成能力的影响。结果 低氧刺激HPAECs 12 h和24 h后,FSTL1的mRNA及蛋白质的表达量均提高（P<0.01）。常氧下外源给予FSTL1,250 μg/L、500 μg/L组的细胞增生活性与对照组相比明显增高（P<0.01）;低氧条件下siRNA干扰组HPAECs增生活性与对照组相比明显降低（P<0.001）。常氧下外源给予250 μg/L的FSTL1刺激24 h后HPAECs黏附数量增多（P<0.001）,生成血管总长度及新生血管数目均增加（P<0.001）。结论 FSTL1促进HPAECs增生、黏附与血管生成。     

The effect of oxidative stress in myocardial cell injury in mice exposed to chronic intermittent hypoxia

Background Obstructive sleep apnea syndrome （OSAS） is an important risk factor for cardiovascular diseases. Chronic intermittent hypoxia （CIH） is considered to be one of the most important causes of cardiovascular diseases in OSA patients. This repeated hypoxia and reoxygenation cycle is similar to hypoxia-reperfusion injury, which initiates oxidative stress. In this study, we observed cardiocytes injury induced by CIH and the effect of N-acetylcysteine （NAC）. Methods Thirty ICR mice were randomly assigned to 3 groups： control, CIH and NAC （CIH＋NAC） groups. Malondialdehyde （MDA） and superoxide dismutase （SOD） of cardiocyte homogenates were measured. Serum lipids were measured by an instrument method. Serum cardiac troponin I （cTnl） was detected by enzyme-linked immunosorbent assays （ELISA）. Myocardium pathological sections were observed. Results （1） The SOD activity and MDA concentration of cardiocyte homogenates in the CIH group were significantly higher than in other groups （P 〈0.005）. The MDA concentration of the NAC group was lower than that of the control group （P 〈0.01）. （2） The serum cTnl concentration of the CIH and NAC groups was significantly higher than that of the control group （P 〈0.01）. （3） Serum triglyceride levels in the NAC group were lower than in the other groups （P 〈0.01）, while there were no significant differences in low density lipoprotein and high density lipoprotein among the three groups. （4） The degeneration of myocardium, transverse striation blurred, and fabric effusion were observed in tissue sections in the CIH and NAC groups. However, normal tissue was found in the control group. Conclusion The oxidative stress induced by CIH can injure cardiocytes and the injury effect can be partially inhibited by NAC.     

N-乙酰半胱氨酸在慢性间歇缺氧小鼠心肌损伤中的作用研究

目的:通过建立慢性间歇缺氧(CIH)模拟阻塞件睡眠呼吸暂停(OSAS)的动物模型,观察CIH对心脏的损伤及其可能的作用机制.方法:ICR鼠33只随机分成3组:慢性间歇缺氧组、N-乙酰半胱氨酸干预组、对照组.硫代巴比妥酸(TBA)法和黄嘌呤氧化酶法分别检测3组实验鼠心肌匀浆中丙二醛(MDA)、超氧化物歧化酶(SOD)在N-乙酰半胱氨酸干预前后的变化.酶联免疫法检测3组鼠血清中心肌肌钙蛋白Ⅰ(cTnI)水平.结果:①慢性间歇缺氧组SOD活性及MDA水平高于对照绀和N-乙酰半胱氨酸干预组(P<0.05),N-乙酰半胱氨酸干预组MDA水平低于对照组(P<0.01);②慢性间歇缺氧组及N-乙酰半胱氨酸干预组cTnI均高于对照组(P<0.01):③组织病理切片结果表明慢性间歇缺氧组及N-乙酰半胱氨酸干预组心肌组织变性,横纹模糊.伴有纤维性渗出物.而对照组正常.结论:OSAS通过氧化应激产生的过量活性氧造成心肌损伤,给予N-乙酰半胱氨酸干预后可部分抑制这种损伤.     

Thioredoxin and impaired spatial learning and memory in the rats exposed to intermittent hypoxia

Background  Obstructive sleep apnea (OSA) can cause cognitive dysfunction and may be a reversible cause of cognitive loss in patients with Alzheimer’s disease (AD). Chronic exposure to intermittent hypoxia (IH), such as encountered in OSA, is marked by neurodegenerative changes in rat brain. We investigated the change of thioredoxin (Trx), spatial learning and memory in rats exposed to chronic intermittent hypoxia (CIH).

Methods  Forty healthy male Sprague-Dawley (SD) rats were randomly divided into four groups of ten each: a CIH+normal saline (CIH+NS group), a N-acetylcystein-treated CIH (CIH+NAC) group, a sham CIH group (sham CIH+NS), and a sham NAC-treated sham CIH (CIH+NAC) group. Spatial learning and memory in each group was assessed with the Morris water maze. Real-time PCR and Western blotting were used to examine mRNA and protein expression of Trx in the hippocampus tissue. The terminal deoxynucleotidyl transferase-mediated dUTP-nick end-labeling (TUNEL) method was used to detect the apoptotic cells of the hippocampus CA1 region.

Results  CIH-rats showed impaired spatial learning and memory in the Morris water maze, including longer mean latencies for the target platform, reduced numbers of passes over the previous target platform and a smaller percentage of time spent in the target quadrant. Trx mRNA and protein levels were significantly decreased in the CIH-hippocampus, meanwhile, an elevated apoptotic index revealed apoptosis of hippocampal neurons of rats exposed to CIH. The rats, which acted better in the Morris water maze, showed higher levels of the Trx mRNA and protein in the hippocampus; apoptotic index of the neurons in the hippocampus of each group was negatively correlated with the Trx mRNA and protein levels.

Conclusion  The Trx deficit likely plays an important role in the impaired spatial learning and memory in the rats exposed to CIH and may work through the apoptosis of neurons in the hippocampus.

     

Hippocampal impairments are associated with intermittent hypoxia of obstructive sleep apnea

Obstructive sleep apnea (OSA), which is the most common sleep-related breathing disorder, is characterized as frequent upper airway collapse and obstruction. It is a treatable disorder but if left untreated is associated with complications in several organ systems. The health risk to OSA patients shows a strong association with acute cardiovascular events, and with chronic conditions. To the central nervous system, OSA causes behavioral and neuropsychologic deficits including daytime sleepiness, depression, impaired memory, mood disorders, cognition deficiencies, language comprehension and expression deficiencies, all of which are compatible with impaired hippocampal function. Furthermore, there exists a significant correlation between disease severity and cognitive deficits in OSA. Children with severe OSA have significantly lower intelligence quotient (IQ) and executive control functions compared to normal children matched for age, gender and ethnicity. This corroborates the findings of several pediatric studies of cognition in childhood OSA, where deficits are reported in general intelligence and some measures of executive function. In studies of OSA, it is difficult to differentiate the effects of its two main pathologic traits, intermittent hypoxia (IH) and sleep fragmentation. Many OSA studies, utilize IH as the only exposure factor in OSA studies. These approaches simplify research process and attain most of the academic goals. IH, continuous hypoxia and intermittent continuous hypoxia can all result in decreases in arterial O₂. There are striking differences to them in the response of physiological systems. There are multiple studies showing that IH treatment in a rodent model of OSA can impair performance of standard water maze tests associated with deficits in spatial learning and memory which most likely are hippocampal-dependent. Cellular damage to the hippocampal cornuammonis 1 (CA1) region likely contributes to neuropsychological impairment among OSA patients, since neural circuits in the hippocampus are important in learning and memory. In this article, studies of hippocampal impairments from IH are reviewed for elucidating the mechanisms and relationships between hippocampal impairments and IH of OSA.

     

阻塞性睡眠呼吸暂停综合征模型大鼠心肌氧化应激的损伤及复氧后的变化

通过复制阻塞性睡眠呼吸暂停综合征（OSAHS）的间歇缺氧（IH）大鼠模型,观察IH对大鼠心肌氧化应激的损伤及其复氧后的变化情况。方法40 只SD 大鼠随机分为4 组,对照组（A 组）10 只,复制30只阻塞性睡眠呼吸暂停综合征的间歇缺氧大鼠模型,其中10 只缺氧组（B 组）,10 只缺氧后复氧组（C 组）,另外10 只持续缺氧组（D 组）。检测各组大鼠血清中丙二醛（MDA）含量和超氧化物歧化酶（SOD）活性,以及心肌组织中还原型谷胱甘肽（GSH）活性。结果与对照组大鼠比较,IH模型大鼠MDA 含量增高,SOD活性降低,心肌组织GSH 活性降低,差异具有统计学意义（ p<0.05）;复氧组大鼠MDA、SOD 和心肌组织GSH活性恢复正常,差异无统计学意义（ p>0.05）;而D 组大鼠MDA 含量增高,SOD 活性降低,心肌组织GSH 活性降低,差异具有统计学意义（p <0.05）。结论OSAHS 存在氧化应激,严重损伤心肌组织,缺氧时MDA 含量、SOD 和GSH 活性改变,复氧后有所恢复。血清MDA含量、SOD 活性及心肌组织GSH活性可以反应氧化应激的严重程度。     

Changes in genioglossus and their association with serum adiponectin levels in rats subjected to chronic intermittent hypoxia

Background The genioglossus （GG） is involved in the maintenance of an open airway for effective breathing.Although the pathogenesis of obstructive sleep apnea hypopnea syndrome （OSAHS） was closely associated with GG dysfunction,its causes and possible treatment have not been elucidated.The aim of the study was to investigate the effects of chronic intermittent hypoxia （CIH） on serum adiponectin levels, electromyograph （EMG） activity and ultrastructure of GG, as well as the effect of an adiponectin supplement in anesthetized rats.Methods Forty-two healthy male Wistar rats were randomly divided into normal control （A）, CIH （B） and adiponectin treatment （C） groups, 14 rats in each group.CIH was performed eight hours per day for five weeks in both groups B and C.Group C received transvenous injection of adiponectin at the dosage of 10 μg per injection, twice a week for five weeks.At the end of the 5th week the GG EMG voltage was measured and compared among the three groups.Transmission electron microscope was used to observe the ultrastructure of the GG.Results CIH caused significant hypoadiponectinemia, weakened activity of GG EMG at both baseline and hypoxia stimulation, and induced ultrastructural pathological changes, such as, myofibril discontinuities, lysis of myofilament,edema of mitochondria and disruption of cristae, vacuolus and lysis of some mitochondria.Venous supplement of adiponectin improved the above pathological changes resulting from CIH.Conclusion CIH resulted in pathological changes in GG＇s EMG and ultrastructure, which could be improved by supplement of adiponectin and be associated with hypoadiponectinemia caused by ClH.