Levels of urinary matrix metalloproteinase-9 (MMP-9) and renal injuries in patients with type 2 diabetic nephropathy

To determine correlations among the levels of urinary MMP-9 and type-IV collagen, hyperglycemia, urinary protein excretion, and renal injuries in patients with type 2 diabetic nephropathy, we measured levels of urinary MMP-9 and protein, blood urea nitrogen (BUN), serum creatinine (s-Cr), fasting plasma glucose (FPG), and glycohemoglobin A1c (HbA1c) in 47 diabetic patients and 14 healthy adults. Urinary type-IV collagen was also measured in 28 diabetic patients and seven healthy adults. Patients with diabetic nephropathy were divided into two groups: 1). patients with normoalbuminuria or microalbuminuria (0-299 mg/g.Cr; n=27), and 2). patients with macroalbuminuria (>300 mg/g.Cr; n=20). The mean level of urinary MMP-9 in group 2 was significantly higher than those in healthy adults (P<0.05), and the levels of urinary MMP-9 in patients with diabetic nephropathy increased in accordance with the clinical stage of the disease. The levels of urinary MMP-9 tended to be correlated with HbA1c in these patients, but the correlation was not statistically significant. The mean level of urinary type-IV collagen in group 2 of patients with diabetic nephropathy was significantly higher than that in group 1 and healthy adults. Levels of urinary type-IV collagen in patients with diabetic nephropathy also increased in accordance with the clinical stage of the disease. The results suggest that measurements of urinary MMP-9, as well as urinary type-IV collagen, may be useful for evaluating the degree of renal injuries in patients with type 2 diabetic nephropathy, especially in the early stage.     

急性冠脉综合征患者血清MMP-9水平的研究

目的探讨急性冠脉综合征(ACS)患者和正常人血清基质金属蛋白酶-9(MMP-9)水平,并评价血清MMP-9水平与冠脉病变程度的相关性。方法对ACS 40例,稳定型心绞痛(SAP)组40例(均接受冠脉造影检查确诊),正常对照组40例,抽取静脉血采用双抗体夹心ELISA测定血清MMP-9的水平,并记录患者冠脉病变支数及Gensini冠脉病变评分,分别与血清MMP-9水平做相关性分析。结果 ACS组血清MMP-9水平明显高于SAP组(P<0.01),SAP组血清MMP-9水平高于正常对照组(P<0.01),血清MMP-9水平与冠脉病变支数(r=0.64,P<0.05)和Gensini冠脉病变评分(r=0.78,P<0.01)均呈正相关,Gensini评分与血清MMP-9浓度的水平呈正相关(r=0.725,P=0.0000)。结论 ACS患者血清MMP-9水平明显增高,测定血清MMP-9水平有可能有助于ACS的诊断及冠脉狭窄程度的评价。     

Elevated serum levels of human matrix metalloproteinase-9 (MMP-9) during the induction of peripheral blood stem cell mobilization by granulocyte colony-stimulating factor (G-CSF)

To investigate the role of matrix metalloproteinases (MMPs) in the mobilization of peripheral blood stem cells stimulated by granulocyte colony-stimulating factor (G-CSF), we analyzed MMP serum levels in 11 healthy donors and 9 patients who had hematological malignancies or germ cell tumors. A dose of 5–10 μg/kg per day of G-CSF (lenograstim) was administered for 4–8 days to each subject. The serum levels of MMP-2, and MMP-9; interleukin-3, -6, -8, and -10; stem cell factor; interferon-γ; and tumor necrosis factor-α were measured both before and during G-CSF administration. MMP-9 was found to be increased in both the cancer patients and the healthy donor group. In contrast, the levels of each of the other factors tested were unchanged. No significant positive correlation was observed between the MMP-9 levels and the number of CD34+ cells. Hence, we found no significant role for MMPs during the mobilization of peripheral blood stem cells stimulated by G-CSF.     

黏膜相关淋巴组织国际预后指数对中国人群黏膜相关淋巴组织淋巴瘤预后的评估价值

目的:探讨黏膜相关淋巴组织(MALT)国际预后指数(IPI)在中国人群MALT淋巴瘤患者中的适用性,并比较不同风险分层方法对MALT淋巴瘤的预后评估价值。方法:回顾2007年1月至2016年12月129例MALT淋巴瘤患者的临床资料,采用Kaplan-Meier法和log-rank法计算并比较MALT-IPI与IPI不同分层分组患者的总体生存率(OS)和无进展生存率(PFS)。结果:129例患者中位发病年龄56岁(22~82岁),其中胃MALT淋巴瘤53例(41.1%),肺MALT淋巴瘤33例(25.6%);Ann ArborⅠ~Ⅱ期71例(55.1%),Ⅲ~Ⅳ期58例(44.9%)。中位随访时间26个月(1~378个月)。总体5年PFS为69.41%,5年OS为90.23%。IPI评分低危、中低危和中高危/高危组患者5年OS、PFS差异无统计学意义;MALT-IPI评分低危、中危和高危组患者5年OS、PFS率逐渐降低,差异有统计学意义(P0.05)。结论:MALT-IPI评分适用于中国人群;相较于IPI评分,MALT-IPI评分对MALT淋巴瘤患者预后具有更好的评估价值。     

P53异常在弥漫大B细胞淋巴瘤中的预后价值

本研究旨在分析P53异常在弥漫大B细胞淋巴瘤(DLBCL)中的预后价值。采用荧光原位杂交法(FISH)对50例DLBCL患者的扁桃体组织进行P53基因检测,同时采集患者外周血用酶联免疫吸附(ELISA)法进行血清P53蛋白含量的检测,了解DLBCL患者P53基因及P53蛋白表达与淋巴瘤预后的关系。结果表明,50例患者中P53缺失者21例,阳性率42.0%,患者血清P53蛋白含量为(176.25±61.25)pg/ml,高于正常对照。经Cox模型似然比检验结果筛选,DLBCL患者的P53异常可作为独立的预后因素。P53基因检测阳性患者的死亡风险高于P53检测阴性者。经FISH检测,组织学P53基因缺失的患者同时有相对较高的血清突变型P53蛋白水平。结论:P53异常可作为DLBCL患者独立的预后因素,在疾病诊断初期即对DLBCL患者的P53表达进行检测有利于准确判断预后。     

Imbalance between matrix metalloproteinases (MMP-9 and MMP-2) and tissue inhibitors of metalloproteinases (TIMP-1 and TIMP-2) in acute respiratory distress syndrome patients

OBJECTIVE: Matrix metalloproteinases (MMPs) are known to be involved in degradation of extracellular matrix. We aimed to assess the role of MMPs and their natural inhibitors (TIMPs) in the genesis and the evolution of acute respiratory distress syndrome (ARDS). DESIGN: Prospective, clinical study. SETTING: Intensive care unit of a university hospital. PATIENTS: Twenty-one patients were assigned to three different groups: Group 1 patients developed ARDS that rapidly resolved in <4 days; Group 2 patients developed ARDS lasting >8 days; Group 3 (control group) patients had clinical criteria for hospital-acquired pneumonia without ARDS. INTERVENTION: Bronchoalveolar lavages were performed on day 0 of the onset of ARDS and on days 4, 8, and 12 for unresolving ARDS. For group 3, the bronchoalveolar lavages were performed on day 0 of the pneumonia. On these bronchoalveolar lavage fluids, we measured the amount of MMP-9 and -2 and their inhibitors TIMP-1 and -2. MEASUREMENTS AND MAIN RESULTS: The amount of MMP-9 measured by enzyme-linked immunosorbent assay was significantly lower in the bronchoalveolar lavages from patients with ARDS (group 1 and group 2) compared with the control group (p <.01) throughout the study. The ratio MMP-9/TIMP-1 was also significantly smaller and was less than one in the two ARDS groups (p <.05) compared with the control group (group 3), where this ratio was greater than one. In the second bronchoalveolar lavages, this ratio was greater than one only in the ARDS group that rapidly resolved (group 1), whereas it stayed less than one when the ARDS was lasting (group 2). Concerning the quantity of MMP-2 and the ratio MMP-2/TIMP-2, there was no statistical difference between the three groups throughout the study. Using zymography, there was no significant difference in the amounts of active and latent MMP-9 between the three groups. Moreover, no significant difference in the quantity of latent and active MMP-2 in the three groups was noted. CONCLUSION: These results suggest that the MMP-9 level and MMP-9/TIMP-1 ratio play a role in the pathogenesis of ARDS and, namely, the imbalance between MMP-9 and TIMP-1 would participate in airway remodeling leading to either short- or long-course ARDS. The ratio MMP-9/TIMP-1 could be a predictive factor of the ARDS evolution.     

胃癌组织中基质金属蛋白酶-9和整合素β3 mRNA表达的临床意义

目的研究基质金属蛋白酶-9（MMP-9）和整合素β3（Integrin β3）mRNA在胃癌组织中的表达及与临床病理参数、肿瘤微血管密度、生存期的关系。方法应用原位杂交和免疫组化,检测105例胃癌组织中MMP-9、Integrinβ3 mRNA和CD34的表达。结果MMP-9和Integrinβ3 mRNA阳性表达率分别为58.10%和60.95%,其阳性表达与胃癌生长方式、浸润深度、脉管侵犯、淋巴结及远处转移均密切相关（P均〈0.01）;MMP-9、Integrin β3 mRNA的阳性表达病例的平均血管数均高于阴性表达病例的平均血管数（P均〈0.05）;MVD值分别与MMP-9和Integrin β3 mRNA的表达水平呈正相关（P均〈0.05）;MMP-9和Integrinβ3 mRNA的阳性表达以及MVD值≥39.5病例的5年生存率显著低于阴性表达和MVD值〈39.5的病例;MMP-9和Integrin β3 mRNA表达存在显著相关性（P〈0.05）。结论MMP-9、Integrinβ3可促进胃癌血管生成,并参与肿瘤浸润转移过程,可以作为反映胃癌生物学行为和判断预后的有效指标。     

基质金属蛋白酶-2及9在胰腺癌组织中表达及意义

目的探讨基质金属蛋白酶（matrix metalloproteinase,MMP）-2及MMP-9在胰腺癌组织中表达情况,及其与胰腺癌临床病理参数及预后的关系。方法应用免疫组织化学方法检测行胰十二指肠根治性切除手术治疗胰腺癌患者79例癌组织及癌旁组织标本,及因胰腺外伤行胰腺部分切除10例患者正常胰腺组织标本中MMP-2及MMP-9表达。结果 MMP-2及MMP-9在正常胰腺组织中无表达或低表达,在胰腺癌组织中表达强度较癌旁组织增高（P〈0.05）;表达强度与肿瘤病理分级、TNM分期及预后均有相关性（P〈0.05）,但经Cox风险回归模型对病理分级、TNM分期进行调整后显示,MMP-2及MMP-9单独或联合表达均不能作为评估胰腺癌预后的独立预测指标。结论胰腺癌组织中MMP-2及MMP-9阳性表达与胰腺癌浸润、转移有关,但不能作为胰腺癌患者预后的独立预测指标。     

MMP-2和MMP-9在早孕不同孕周滋养细胞中的表达及意义

目的:探讨MMP-2和MMP-9在早孕胎盘滋养细胞中的表达及意义。方法:通过免疫组织化学技术及West-ern blot技术检测早孕早期和早孕晚期绒毛组织中MMP-2和MMP-9蛋白的表达。结果:MMP-2和MMP-9蛋白主要定位在绒毛细胞滋养细胞和合体细胞滋养细胞胞浆内,绒毛间质细胞内亦有少量阳性染色,且早孕早期绒毛滋养细胞中MMP-2表达量高于早孕晚期(P0.05),而MMP-9表达量在早孕晚期高于早期(P0.05)。结论:MMP-2和MMP-9在调节滋养细胞浸润过程中起重要作用,且在早孕不同时期,二者表达不同,为深入探讨MMPs在滋养细胞浸润机制中的作用提供理论基础。     

异丙酚对内毒素诱导肺损伤MMP-2和MMP-9的影响

目的:研究异丙酚对急性肺损伤时基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)的影响。方法:健康SD大鼠30只随机分为3组:对照组经股静脉注射生理盐水;内毒素组经股静脉注射内毒素5 mg／kg后泵注生理盐水;异丙酚组经股静脉注射内毒素5 mg／kg后泵注异丙酚10 mg.kg1.h1。采取经股静脉注射内毒素复制肺损伤模型(5 mg/ kg)。4 h后放血处死动物,对气管肺泡灌洗液(BALF)行白细胞计数及分类,ELISA法检测血清和BALF中的MMP-2、MMP-9的活性。结果:内毒素组白细胞总数、巨噬细胞、中性粒细胞和淋巴细胞均明显高于其他两组(P<0．01)。异丙酚组白细胞总数明显高于对照组(P<0．01),巨噬细胞、中性粒细胞和淋巴细胞高于对照组(P<0．05);内毒素组血清和BALF中的MMP-2、MMP-9均明显高于其他两组(P<0．01),异丙酚组血清的MMP-2高于对照组(P<0．05)。结论:异丙酚可产生与抑制MMP-2、MMP-9活性相关的肺保护作用。     

心肺复苏大鼠脑组织基质金属蛋白酶与血脑屏障的变化及其抑制剂的作用

目的 探讨心肺复苏早期大鼠脑组织基质金属蛋白酶-9(MMP-9)的表达和血脑屏障的变化规律及MMP-9抑制剂SB-3CT的作用.方法 将健康Sprague-Dawley(SD)雄性大鼠120只随机分为假手术对照组、复苏对照组和复苏治疗组,实验地点在中山大学北校区动物实验中心.动物模型采用气管夹闭窒息法,自主循环恢复定义为恢复室上性心律,平均动脉压≥60mmHg并且维持5 min以上.假手术对照组仅进行麻醉和气管插管,复苏治疗组于自主循环恢复后立即腹腔内注射SB-3CT 25mg/kg.复苏对照组于自主循环恢复后不注射SB-3CT.在即刻及3,9,24 h和48 h时间点分5个时间点处死大鼠后,取样,测定脑组织MMP-9蛋白的表达和检测腩组织MMP-9 mRNA,观察脑含水量和伊文思蓝含量的变化,使用电镜观察脑组织的超微结构.统计分析采用方差分析法.结果 假手术对照组脑组织MMP-9表达、MMP-9 mRNA、脑含水量和伊文思蓝含量在各时间点均无明显变化,p 值分别为1.0000,0.6831,0.7124和0.9975.复苏对照组心肺复苏后上述指标均明显变化在24 h到达高峰,P 值分别为0.0264,0.0163,0.0000和0.0412,与假手术组比较有统计学意义.复苏治疗组心肺复苏后上述指标变化与复苏对照组相似,但变化程度较复苏对照组轻,P 值分别为0.0392,O.0373,0.O004和O.0180.脑组织损伤情况通过电镜观察得到证实.结论 大鼠心肺复苏后脑MMP-9,MMP-9 mRNA、脑含水量和伊文思蓝含量明显升高,血脑屏障受到破坏;电镜观察证实脑组织损伤明显;这些变化在心肺复苏后24 h时点达高峰.应用特异性MMP-9抑制剂SB-3CT可显减少MMP-9的表达,减轻脑水肿,对心肺复苏后脑缺血-再灌注损伤有明显保护作用.     

凝血酶致大鼠脑水肿与脑内MMP-9、MMP-2蛋白表达关系的实验研究

目的探讨凝血酶对大鼠脑内MMP-9、MMP-2蛋白表达的影响。方法 Wistar大鼠随机分为假手术组、对照组及凝血酶实验组。实验组脑内注入凝血酶,在不同时间点采用干湿重法测脑水含量,Western blog方法检测脑内MMP-9、MMP-2蛋白的表达。对照组注入等量生理盐水。结果脑组织水含量在凝血酶注入后12 h开始增加,3 d达高峰。MMP-9在注射凝血酶后12 h开始明显表达增加,与对照组相比差异显著(P0.01),3 d达高峰,随后持续下降。MMP-2在注射凝血酶后24h才开始有明显表达,后持续增多,5 d达高峰,随后有所下降,与对照组相比差异显著(P0.05)。结论凝血酶在脑出血后脑水肿及脑组织损伤中起了关键的作用,MMP-9、MMP-2参与了急性期脑水肿过程。     

组织微阵列检测结直肠癌组织中MMP-2、MMP-9和TIMP-2蛋白的表达

目的 探讨MMP-2、MMP-9 和TIMP-2蛋白表达与结直肠癌侵袭转移的关系,寻找用于预测结直肠癌侵袭转移的分子标记物.方法 组织微阵列结合免疫组化技术检测结直肠癌及其癌旁正常肠黏膜上皮中的MMP-2、MMP-9 和TIMP-2蛋白表达.结果 结直肠癌组织中,MMP-9蛋白阳性表达率显著高于癌旁肠黏膜组织(P<0.001),TIMP-2蛋白阳性表达率显著低于癌旁黏膜组织(P<0.05).浸润至肠壁浆膜层的结直肠癌和Dukes'C、D期癌组织的MMP-2蛋白阳性表达率显著高于浸润肠壁浅、深平滑肌层和Dukes'A、 B期结直肠癌(P<0.05);肠壁局部淋巴结转移的结直肠癌中MMP-2、MMP-9 蛋白阳性表达率显著高于无淋巴结转移癌(P<0.05);Dukes'A、B期结直肠癌TIMP2蛋白阳性表达率显著高于Dukes'C、D期(P<0.05).TIMP2蛋白阳性的结直肠癌生存时间显著长于TIMP2阴性的结直肠癌(P<0.05).结直肠癌中MMP-2蛋白阳性表达与MMP-9表达呈正相关(P＜0.001),但TIMP-2蛋白阳性表达与MMP-2表达呈显著负相关(P<0.05).二变量多因素回归分析显示,MMP-2蛋白表达、癌组织的浸润深度和Dukes分期可作为预测结直肠癌淋巴结转移的独立指标.结论 结直肠癌MMP-9和TIMP-2蛋白共同高表达及MMP-2与TIMP-2蛋白的表达失衡在结直肠癌侵袭、转移中起重要作用.MMP-2蛋白表达可作为结直肠癌淋巴结转移的独立预测指标.     

肝内胆管癌TRIM44、基质金属蛋白酶9蛋白的表达及临床意义

目的:探讨TRIM44和基质金属蛋白酶9(MMP9)蛋白在肝内胆管癌(ICC)中的表达及临床意义。方法:采用免疫组织化学法检测87例ICC患者肿瘤组织TRIM44、MMP9蛋白的表达,进一步分析两者表达与患者临床病理指标及预后的相关性;采用Spearman相关性分析探讨TRIM44和MMP9表达的相关性;采用Kaplan-Meier法和Cox风险回归模型分析TRIM44、MMP9表达对患者预后的影响。结果:ICC肿瘤组织TRIM44、MMP9蛋白呈过表达状态,且TRIM44与MMP9表达正相关(P0.001)。TRIM44与淋巴结转移显著相关(P=0.014);MMP9与肿瘤大小、AFP水平与淋巴结转移显著正相关(P0.05),两者同时过表达提示患者预后不良。结论:ICC组织TRIM44和MMP9呈过表达,且二者密切相关;两者同时高表达提示ICC患者预后不良。     

C反应蛋白/白蛋白比值在胃MALT淋巴瘤中的预后价值

目的：研究C反应蛋白与白蛋白比值（C-creative protein to albumin ratio,CAR）在胃黏膜相关淋巴组织淋巴瘤中的预后价值。方法：通过X-tile软件获取最佳CAR临界值0.05,根据此将患者分为低CAR组（66例）和高CAR组（27例）。分析两组患者的基线数据及生存资料。应用COX回归分析和Kaplan-Meier法分析CAR在胃MALT淋巴瘤中的预后意义。结果：C反应蛋白在76例患者中正常水平,17例患者中升高。白蛋白在87例患者中正常,6例患者中降低。CRP值与ALB值存在相关性（χ2=6.89,P=0.009）。高CAR组中高龄（70岁以上）患者更多（33.3% vs 13.6%,P=0.029）,具有更高的CRP水平（5.40 [2.70,11.50]mg/L vs 0.60 [0.40,1]mg/L,P=0.000）、β2-MG水平（2.83 [2.25,3.49]mg/L vs 1.94 [1.63,2.33]mg/L,P=0.000）和更低的ALB水平(39.22±4.07g/L vs 43.64±4.10g/L,P=0.000）,贫血发生率更高（33.3% vs 12.1%,P=0.035）。COX单因素分析显示最终疗效（HR=0.0.027, 95% CI=0.003-0.266, P=0.002）、白蛋白水平（HR=0.676, 95% CI=0.494-0.924, P=0.014）和免疫球蛋白G（IgG）水平（HR=0.634, 95% CI=0.427-0.944, P=0.025）具有统计学意义。然而,多因素分析结果提升仅IgG对预后存在统计学意义（HR=0.528, 95% CI=0.304-0.915, P=0.023）。低CAR组的总体生存期（Overall survival,OS）更长（P=0.020）,中位OS达172.8个月。单独应用MALT-IPI评分对胃MALT患者进行预后评估并无统计学意义（(P=0.358）。而CAR联合MALT-IPI评分（高CAR记1分,低CAR记0分,与MALT-IPI值相加）对胃MALT患者进行预后评价存在显著的统计学意义（P=0.042）,优于单独应用MALT-IPI评分或单独应用CAR。结论：CAR是评估胃MALT淋巴瘤患者预后的有效预测因子,值得进一步研究分析。     

微创术对脑出血后脑水肿患者血浆明胶酶B的影响

目的探讨高血压性脑出血微创术对清除血肿后脑水肿患者血浆明胶酶B(MMP-9)的影响。方法127例脑出血患者随即分为内科治疗组60例、微创术血肿抽吸引流组67例;采用酶联免疫法(ELISA)测定脑出血后第3天、第7天和第21天血浆MMP-9含量。结果微创组和内科治疗组血浆中MMP-9含量均升高;两组治疗后第3、7天的含量与治疗前(发病24h内)比较,差异有统计学意义(P<0.05);两组治疗后不同时间点血浆中MMP-9含量比较,差异有统计学意义(P<0.05)。结论微创组能减少患者血浆MMP-9含量的增加。     

急性髓系白血病82例患者VEGF与MMP-2、MMP-9的相关性研究

为了探讨急性髓系白血病（AML）患者中血管内皮生长因子（VEGF）与基质金属蛋白酶MMP-2、MMP-9的相互关系及二者在AML中的意义，采用半定量RT—PCR技术检测AML患者与正常人骨髓单个核细胞（MNC）MMP-2 mRNA、MMP-9 mRNA、VEOF mRNA的表达，用明胶酶谱的方法测定原代MNC和HL-60细胞分泌的MMP-2、MMP-9的活性。应用ELISA方法检测AML患者血清中VEGF蛋白的水平，分析VEGF和MMP-2、MMP-9 mRNA之间的关系。结果显示：AML患者MMP-2 mRNA、MMP-9 mRNA与VEGF mRNA的表达和VEGF蛋白水平呈正相关，缓解期患者和正常对照无相关性；VEGF阳性组发生髓外浸润率明显高于阴性组；VEOF上调HL-60细胞中bcl-2的表达：结论：AML患者中MMP-2，MMP-9的表达和VEGF具有正相关性，VEGF可以上调部分AML患者中MMP-2，MMP-9的表达，VEOF可能与MMP-2，MMP-9共同参与了白血病髓外浸润的发生。     

脓毒症大鼠肺基质金属蛋白酶-2/9表达与血必净干预

目的 观察创伤弧菌脓毒症大鼠肺基质金属蛋白酶(MMP)-2/9和组织型金属蛋白酶抑制剂(TIMP)-1/2的动态表达及血必净干预.方法 温州医学院生命科学院实验室,清洁级SD大鼠110只,随机(随机数字法)分为正常对照组(A组,n=10)、创伤弧菌脓毒症组(B组,n=50,采用大鼠左下肢皮下注射创伤弧菌悬液制作创伤弧菌脓毒症大鼠模型)及血必净干预组(C组,n=50,感染后0.5 h腹腔注射血必净4 mL/kg).B、C组大鼠于染菌后1,6,12,24,48 h麻醉后活杀,留取右肺标本.观察大鼠行为学变化,采用考马斯亮蓝法测肺通透性,采用逆转录-聚合酶链式反应(RT-PCR)法测肺MMP-2/9,TIMP-1/2 mRNA的表达,免疫组化法和双抗体夹心酶联免疫吸附法(ELISA)测肺MMP-2/9和TIMP-1/2的表达.数据采用单因素方差分析,并用LSD-t法进行组间两两比较,以P＜0.05为差异有统计学意义.结果 B组和C组肺通透性显著高于A组,C组显著低于B组.B组和C组MMP-2/9,TIMP-1/2mRNA显著升高,B组分别于6 h(0.344±0.108),6 h(1.230±0.377),12 h(0.523±0.098),12 h(0.280±0.070)达高峰(P＜0.05),C组分别于12 h(0.256±0.074),6 h(0.968±0.225),12 h(0.746±0.316),12 h(0.356±0.035)达高峰(P＜0.05),C组MMP-2/9mRNA升高趋势显著低于B组(P＜0.05),TIMP-1/2mRNA显著高于B组(P＜0.05).B组和C组MMP-2/9,TIMP-1/2蛋白也升高,B组分别于12 h(0.692±0.191),12 h(0.061±0.017),24 h(1384.42±91),24 h(41.04±3.60)达高峰(P＜0.05);C组分别于24 h(0.217±0.065),12 h(0.045±0.013),24 h(1617.22±103),24 h(47.66±3.58)达高峰(P＜0.05);C组MMP-2/9蛋白升高趋势低于B组(P＜0.05),TIMP-1/2蛋白早期与B组差别不大,后期显著高于B组(P＜0.05).结论 MMP/TIMP比例失衡是创伤弧菌脓毒症大鼠肺损伤机制之一,血必净可促进MMP/TIMP比例恢复平衡,对创伤弧菌脓毒症大鼠肺损伤具有保护作用.

Abstract：

Objective To detect the expression of MMP-2/9 and TIMP-1/2 in the lung of Vibrio vulnificus sepsis rats and observe the intervention of Xuebijing injection. Method One hundred and ten SD rats of clean grade were randomly(random number) divided into normal control group (group A, n = 10),Vibrio vulnificus sepsis group (group B, n = 50. Sepsis was reproduced in rats with subcutaneous injection in left lower limb with Vibrio vulnificus) and Xuebijin intervention group ( group C, n = 50. Rats were intraperitoneal(ip) with the dose of Xuebijing 4mL/kg at the time of 30 min later after infection). The rats in group B and C were sacrificed at 1 h, 6 h, 12 h, 24 h, 48 h after infection, the expression of MMP-2/9 and TIMP-1/2 were examined by PCR, Immunohistochemistry or ELISA methods, the lung permeability were measured by Coomassie Brilliant Blue method. Experimental data used single factor analysis of variance, and between groups by LSD method for pairwise comparison,P ＜0.05 statistically significant difference. Results The lung permeability increased both in group B and C compared with group A,and in group B were relatively higher. The lung MMP-2/9, TIMP-1/2mRNA expression in groups B and C compared with in group A was markedly higher, and reached the peak at 6 h(0. 344 ± 0. 108 ),6 h ( 1. 230 ± 0.377 ), 12 h (0.523 ±0.098),12 h(0.280±0.070) (P＜0.05) in group B while at 12 h(0.256 ±0.074),6 h(0.968±0.225) ,12 h(0.746 ±0. 316) ,12 h(0.356 ±0.035) (P ＜0. 05) in group C; the MMP-2/9mRNA expression in group C decreased(P＜0. 05) compared with the group B while the TIMP-1/2mRNA expression increased(P＜0. 05). The lung MMP-2/9, TIMP-1/2 protein expression in groups B and C compared with the group A(0.345±0.109) also increased, and the peak was at 12 h (0. 692 ± 0. 191 ), 12 h (0. 061 ±0.017) ,24 h(1384.42 ±91) ,24 h(41.04 ±3.60)in group B while at 24 h(0. 217 ±0.065) ,12 h(0. 045± 0. 013 ) ,24 h ( 1617.22 ± 103 ) ,24 h (47.66 ± 3.58 )in group C, the MMP-2/9 protein expression in group C was lower than in group B(P＜0.05), the TIMP-1/2 protein expression in group C was similar to in group B early while marked increased(P＜0.05)later. Conclusions MMP/TIMP imbalance was one of the mechanisms of the lung injury in the rats with Vibrio vulnificus sepsis, Xuebijing could restore the balance of MMP/TIMP ratio.     

来那度胺在复发难治性非霍奇金B细胞淋巴瘤治疗中的应用

复发难治性非霍奇金淋巴瘤（RR NHL）患者总体预后不佳。越来越多的新药与靶向药应用于临床以改善RR NHL的生存。来那度胺因具有免疫调节、抑制血管生成、直接抗肿瘤活性等作用,被用于NHL多种亚型的治疗,无论是初诊或难治复发,均取得了较好的疗效,尤其在B细胞淋巴瘤中。本文就来那度胺在复发难治性非霍奇金B细胞淋巴瘤（RR B NHL）中的应用进展进行综述。     

MMP-2和MMP-9在急性B淋巴细胞白血病中的表达及临床意义

本研究探讨急性B淋巴细胞白血病（B-ALL）患者骨髓细胞中基质金属蛋白酶-2和-9（MMP-2,MMP-9）的表达及临床意义。采用半定量RT-PCR方法检测初治、复发B-ALL患者和正常对照骨髓中单个核细胞MMP-2,MMP-9mRNA的表达。采用明胶酶谱检测B-ALL患者和正常对照骨髓单个核细胞孵育上清中MMP-2,MMP-9的酶活性。结果表明,初治、复发组B—ALL患者中MMP-2表达率明显高于正常对照组（P〈0．05）;MMP-9表达率明显低于正常对照组（P〈0．05）。髓外浸润组患者MMP-2和MMP-9表达率均明显高于无髓外浸润组（P〈0．05）,而MMP-2／MMP-9（＋）组髓外浸润发生率明显高于MMP-2／MMP-9（-）组。高危组B—ALL患者MMP-9表达率明显高于标危组,而两组间MMP-2表达率无显著性差异（P〉0．05）。结论：B-ALL患者白血病细胞可以产生MMP-2,MMP-9,可能参与了B-ALL的髓外浸润,MMP-9表达可能提示预后不良。