糖皮质激素对急性胰腺炎大鼠胰腺细胞凋亡的影响及其意义

目的　探讨糖皮质激素对急性胰腺炎 (AP)大鼠胰腺细胞凋亡的影响及其意义。方法　将SD大鼠 5 4只随机分为 3组 :正常对照组 ,胰腺炎组和激素治疗组 ,每组 18只。经十二指肠行胆胰管逆行加压注射 4 %的牛磺胆酸钠 ,诱导大鼠 AP模型 ,于术后 3h、6 h和 12 h采取断颈方法分批处死动物 ,应用末端脱氧核苷酸转换酶 (Td T)介导的原位末端标记 (TUNEL )法检测胰腺组织细胞凋亡变化 ,观察各组大鼠胰腺组织病理改变。结果　 (1) AP大鼠的胰腺凋亡细胞增多 ,与对照组比较均有显著差异 (P<0 .0 1) ,注射激素后 ,胰腺凋亡细胞减少 ,6 h、12 h的凋亡指数均显著低于对应时相的 AP组 (P<0 .0 5 ) ;(2 )激素治疗后 ,AP大鼠胰腺炎症细胞、坏死细胞明显减少 ,病变减轻 ,6 h、12 h病理评分均显著低于 AP组 (P<0 .0 5 )。结论　糖皮质激素具有抑制胰腺细胞凋亡的作用 ,保护腺泡细胞、阻止细胞死亡可能是糖皮质激素减轻 AP病变严重程度的一个重要因素。     

急性梗阻性胰腺炎大鼠胰腺细胞凋亡及其内分泌变化的实验研究

目的 探讨急性梗阻性胰腺炎(acute obstructive pancreatitis,AOP)大鼠胰腺细胞凋亡的发生规律及其内分泌相关激素的变化.方法 采用胆胰管结扎方法建立AOP大鼠模型,分别于梗阻后8、12 h取血检测胰岛素和胰高血糖素以及血清淀粉酶水平;取胰腺组织,采用TUNEL法与Annexin-V/PI 双染法流式细胞仪检测胰腺细胞的凋亡.结果 AOP大鼠在胆胰管结扎8、12 h时的血清淀粉酶分别为(1198±687)U/L和(1698±1103)U/L,胰岛素分别为(8.1±5.8)ng/ml和(12.7±6.9)ng/L,胰高血糖素分别为(6.8 ±4.6)ng/ml和(7.3±2.9)ng/ml,均显著高于假手术对照组的(404±222)U/L、(5.6±2.7)ng/ml和(2.6±2.1)ng/ml(P<0.05).胰腺组织中外分泌部分腺泡细胞与内分泌部分胰岛细胞均发生凋亡,8、12 h的细胞凋亡率分别为(20.5±11.2)%和(15.5±8.9)%,均显著高于假手术组的(4.2±1.6)%(P<0.05).结论 AOP大鼠的胰腺组织中内、外分泌腺细胞均发生凋亡,这可能是AOP内分泌激素改变的病理生理学基础.     

急性梗阻性胰腺炎大鼠胰腺细胞凋亡及其内分泌变化的实验研究

目的探讨急性梗阻性胰腺炎（acute obstructive pancreatitis,AOP）大鼠胰腺细胞凋亡的发生规律及其内分泌相关激素的变化。方法采用胆胰管结扎方法建立AOP大鼠模型,分别于梗阻后8、12h取血检测胰岛素和胰高血糖素以及血清淀粉酶水平;取胰腺组织,采用TUNEL法与Annexin—Ⅴ／PI双染法流式细胞仪检测胰腺细胞的凋亡。结果AOP大鼠在胆胰管结扎8、12h时的血清淀粉酶分别为（1198±687）U／L和（1698±1103）U／L,胰岛素分别为（8．1±5．8）ng／ml和（12．7±6．9）ng／L,胰高血糖素分别为（6．8±4．6）ng／ml和（7．3±2．9）ng／ml,均显著高于假手术对照组的（404±222）U／L、（5．6±2．7）ng/ml和（2．6±2．1）ng／ml（P〈0．05）。胰腺组织中外分泌部分腺泡细胞与内分泌部分胰岛细胞均发生凋亡,8、12h的细胞凋亡率分别为（20．5±11．2）％和（15．5±8．9）％,均显著高于假手术组的（4．2±1．6）％（P〈0．05）。结论AOP大鼠的胰腺组织中内、外分泌腺细胞均发生凋亡,这可能是AOP内分泌激素改变的病理生理学基础。     

糖皮质激素对急性胰腺炎大鼠胰腺细胞凋亡的影响及其意义

目的探讨糖皮质激素对急性胰腺炎(AP)大鼠胰腺细胞凋亡的影响及其意义.方法将SD大鼠54只随机分为3组:正常对照组,胰腺炎组和激素治疗组,每组18只.经十二指肠行胆胰管逆行加压注射4%的牛磺胆酸钠,诱导大鼠AP模型,于术后3 h、6 h和12 h采取断颈方法分批处死动物,应用末端脱氧核苷酸转换酶(TdT)介导的原位末端标记(TUNEL)法检测胰腺组织细胞凋亡变化,观察各组大鼠胰腺组织病理改变.结果(1)AP大鼠的胰腺凋亡细胞增多,与对照组比较均有显著差异(P＜0.01),注射激素后,胰腺凋亡细胞减少,6 h、12 h的凋亡指数均显著低于对应时相的AP组(P＜0.05);(2)激素治疗后,AP大鼠胰腺炎症细胞、坏死细胞明显减少,病变减轻,6 h、12 h病理评分均显著低于AP组(P＜0.05).结论糖皮质激素具有抑制胰腺细胞凋亡的作用,保护腺泡细胞、阻止细胞死亡可能是糖皮质激素减轻AP病变严重程度的一个重要因素.     

抗氧化剂对大鼠重症急性胰腺炎胰腺腺泡细胞凋亡的影响

目的探讨四氢化吡咯二硫代氨基甲酸酯（PDTC）对重症急性胰腺炎（SAP）胰腺腺泡细胞凋亡的影响。方法SD大鼠72只，随机分为：假手术组（sham operation，SO）、SAP组和PDTC组。SAP模型采用5％牛磺胆酸钠1ml/kg胰胆管逆行穿刺注射建立，PDTC组在造模前1h给予腹腔注射PDTC（1130mg/kg），术后分4个时段（1、3、6、12h）分批进行腹主动脉采血后处死，取胰腺组织作病理切片与液氮冻存。胰腺腺泡细胞的凋亡检测应用TUNEL法、电镜以及免疫组化法检测胰腺组织Caspase-3的表达；核因子（NF）-κB活化的检测应用免疫组化法。同时观察各组血清淀粉酶、脂肪酶水平及胰腺组织病理学评分。结果SAP组各时间点血清淀粉酶及脂肪酶水平及胰腺组织病理组织学评分较SO组显著增高（P〈0．05）。PDTC治疗组血清淀粉酶、脂肪酶水平较SAP组明显降低；胰腺组织病理组织学评分明显改善。PDTC治疗后3、6、12h胰腺组织Caspase-3的表达显著高于SAP组（P〈0．01），而在1h无统计学差异；各时间点胰腺腺泡细胞凋广指数显著高于SAP组（P〈0．01）；NF—κB的活化显著低于SAP组（P〈0．01）。结论SAP时，PDTC可能通过抑制NF—κB的活化，从而抑制NF—κB介导胰腺细胞的抗凋亡效应，减少胰腺腺泡细胞坏死。     

大鼠急性胰腺炎时胰腺腺泡细胞凋亡及Bax,Caspase-8的表达

目的:研究大鼠急性胰腺炎腺泡细胞凋亡情况,凋亡调控基因Bax与凋亡蛋白酶Caspase-8的表达及其同疾病严重程度的关系.方法:胆胰管逆行注入不同浓度去氧胆酸钠方法制备大鼠急性胰腺炎模型,设假手术(SO)组、急性水肿性胰腺炎(AEP)组和急性坏死性胰腺炎(ANP)组.采用TUNEL技术检测胰腺腺泡细胞的凋亡,RT-PCR与免疫组化方法分别分析胰腺组织Bax,Caspase-8 mRNA及蛋白的表达,对胰腺组织进行病理学评分并测定血清淀粉酶及IL-6,TNF-α含量.结果:与SO组比较,AEP与ANP组胰腺组织显示不同程度的病理损害,血清淀粉酶(63 413±6118,1 532 134±17 654 nkat/L vs 15 736±483 nkat/L,P＜0.01)及TNF-α(1.86±0.13,2.97±0.14μg/L vs 0.95±0.08 μg/L,P＜0.01),IL-6 (47.10±7.05,170.10±7.59 ng/L vs 29.20±4.47 ng/L,P＜0.01)浓度显著升高,且ANP组显著高于AEP组(P＜0.05);AEP与ANP组腺泡细胞凋亡指数显著升高(22.09±3.71,6.50±1.58 vs 0.13±0.05,P＜0.01),但ANP组显著低于AEP组(P＜0.05).同时发现,AEP与ANP组胰腺组织Bax (mRNA:1.530±0.501,1.046±0.337;蛋白:453.7±30.5,339.4±26.7)和Caspase-8(mRNA:0.595±0.17,0.505±0.173;蛋白:3606±337,3134±231) mRNA及蛋白表达水平均显著高于SO组(Bax mRNA:0.613±0.244,Bax蛋白:245.2±30.0;Caspase-8mRNA:0.357±0.130,Caspase-8蛋白:2396±266)(P＜0.01),ANP组Bax mRNA及蛋白表达水平显著低于AEP组(1.046±0.337,339.4±26.7 vs 1.530±0.501,453.7±30.5,P＜0.05),ANP组Caspase-8 mRNA及蛋白表达水平低于AEP组,但差异不具有显著性意义.结论:急性胰腺炎时胰腺腺泡细胞发生凋亡伴随凋亡调控基因Bax与凋亡蛋白酶Caspase-8表达增加,并同病情严重程度呈负相关关系.     

扑热息痛引起肝细胞损害的机制

目的:探讨肝细胞凋亡在扑热息痛(acetaminophen, AAP)肝损害中作用．方法:建立SD大鼠AAP肝损害模型;分别于给药后3,6,12,24 h处死大鼠,AAP组和对照组测定血清ALT水平,HE染色光镜下观察肝脏病理改变,原位末端标记(TUNEL)法和透射电镜检测肝细胞凋亡．结果:AAP组各时间点血清ALT(nkat／L)水平均显著高于对照组(3,6,12,24 h:1167±151 vs587±89,2154±255vs573±76,4221± 929vs751±82,13 203±1393 vs 780±161, P<0．01),随时间进行性升高,24 h达高峰; AAP组可见不同程度肝细胞坏死,随时间进行性加重,24 h达高峰,对照组未见肝细胞坏死; AAP组中央静脉周围可见大量凋亡细胞,12 h 达高峰,对照组罕见凋亡细胞,AAP组各时间点肝细胞凋亡指数(AI)均显著高于对照组 (3,6,12,24 h:13．1％±2．9％vs 1．8％±0．5％, 24．8％±5．3％vs 1．7％±0．5％,40．4％±3．7％vs 2．0％±0．4％,35．3％±3．5％vs1．92％±0．3％, P<0．01);透射电镜下观察,AAP组可见明显的肝细胞凋亡现象,12 h最易见到,对照组肝组织超微结构基本正常．结论:AAP肝损害过程中同时存在肝细胞坏死和凋亡,早期(给药后12 h内)以凋亡为主, 后期(给药后24 h)以坏死为主．     

槲皮素对结肠癌HT-29细胞增殖及周期的影响

目的:探讨槲皮素(Qu)对结肠癌HT-29细胞增殖和凋亡影响的分子机制．方法:以40×10-6,80×10-6,160×10-6mol／L的槲皮素作用结肠癌HT-29细胞,以溶剂为对照组,采用MTT试验、流式细胞分析、免疫细胞化学和RT-PCR等方法观察槲皮素对结肠癌细胞增殖,细胞周期,细胞凋亡,及Caspase-3 蛋白表达、Caspase-3、bcl-2、bax mRNA表达的影响．结果:40×10-6mol／L Qu明显促进HT-29细胞增殖(P<0．05),80×10-6,160×10-6mol／L Qu 明显抑制细胞增殖(P<0．05或P<0．01),呈时间 (?)效应．40×10-6,80×10-6,160×10-6mol/L槲皮素作用HT-29细胞72 h,其增殖率分别为 (111．8±9．6)％,(64．6±8.3)％和(26．1±5．7)％, G0／G1期细胞分别为(32．7±5．4)％、(58．1± 18．3)％和(71．6±20．8)％,S期细胞分别为(48．6 ±17．5)％、(27．4±13．4)％和(15．4±10．1)％,细胞凋亡率分别为(7．0±1．3)％、(15．6±3．6)％和(26．4±6．2)％,80×10-6,160×10-6mol／L能明显提高G0／G1期细胞(P<0．01),明显降低S期细胞(P<0．01),细胞凋亡明显增加(P<0．01)．80 ×10-6,160×10-6mol／L的Qu增加细胞中bax mRNA,Caspase-3 mRNA及其蛋白的表达,降低 bcl-2 mRNA的表达．40×10-6mol／L的Qu增加 Caspasc-3 mRNA表达,但其蛋白表达未见明显增加,细胞增殖明显增加．结论:槲皮素能促进结肠癌HT-29细胞增殖, 也能诱导细胞凋亡,其机制可能是通过上调 Caspase-3和bax表达,降低bcl-2表达来实现的．     

同型半胱氨酸硫内酯诱导半胱氨酸天冬氨酸蛋白酶12途径对内皮细胞凋亡的影响

目的探讨同型半胱氨酸硫内酯(HTL)是否通过半胱氨酸天冬氨酸蛋白酶(Caspase)12凋亡途径影响内皮细胞生长。方法体外培养内皮细胞ECV304,先将0、50、100和200μmol/L的HTL干预细胞24h,MTT法检测细胞增殖抑制率;随后以200μmol/L的HTL干预0h、3h、16h和24h,流式细胞术检测细胞周期和细胞凋亡情况,再以200μmol/L HTL刺激细胞为观察组(3、16和24h),不加HTL刺激的细胞为对照组,2组分别采用免疫组织化学染色和Western Blot法检测Caspase-12、Caspase-3和Bcl-2蛋白表达情况。结果 100和200μmol/L的HTL作用细胞24h,细胞活性分别为0.76±0.01、0.73±0.01;200μmol/L HTL对细胞的抑制作用具有时间依赖性,与0h比较,3、16和24h的细胞活性下降明显(0.87±0.04、0.83±0.04、0.78±0.01 vs 0.90±0.07,P<0.01)。与对照组比较,观察组Caspase-12蛋白、Caspase-3蛋白表达增加(P<0.05,P<0.01);Bcl-2蛋白先增高后降低(P<0.01)。结论 Caspase-12途径参与HTL致细胞凋亡的过程,Bcl-2也参与其调控。     

腹腔注射左旋精氨酸诱导急性坏死性胰腺炎大鼠模型

目的:通过大剂量左旋精氨酸(1-arginine) ip诱导大鼠急性胰腺炎(acute necrotizing pancreatitis,ANP)模式,探讨此模型制备的方法和机制．方法:将60只SD大鼠随机分为正常对照组(C组,n=24),ANP模型组(A组,n=36)．C组接受生理盐水对照;A组用60 g/L左旋精氨酸分3次ip建立ANP模型．分别观察两组大体病理变化、光镜下病理评分、血清淀粉酶水平．结果:1-arginine ip后24 h可观察到集中于小叶边缘区的大片胰腺组织坏死、腺小叶结构消失,A组的病理评分(4 h:4．45±1．33 vs 0．50±0．55．P<0．01;12 h:5．33±1．66 vs 0．67±0．82．P<0．01;24 h:7．89±1．67 vs 0．67±0．82,P<0．01;36 h:8．33±1．12 vs 0．67±0．82, P<0．01)、血清淀粉酶(4 h:8296．16±1028．21 nkat／L vs 6315．10±816．83 nkat／L,P<0．01;12 h: 11 255．92±2565．18 nkat／L vs 5867．84±632．29 nkat／L,P<0．01;24 h:54 424．22±27 125．09 nkat／L vs 6078．05±1070．88 nkat／L．P<0．01; 36 h:28 494．53±12 278．62 nkat／L vs 6286．26±1074．38 nkat／L,P<0．01)各时点都比C组明显升高．结论:采用分3次ip 60 g／L左旋精氨酸方法可成功诱导ANP模型．     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.