原代培养大鼠肝星状细胞、枯否氏细胞及肝素的干预作用

目的同步分离培养大鼠肝星状细胞及枯否细胞,应用肝素进行干预,观察肝素在体外对肝星状细胞及枯否细胞的影响.方法应用Nycodenz一步密度梯度离心法一步分离肝纤维化大鼠的肝星状细胞及枯否细胞.分别将不同浓度的肝素加入肝星状细胞和枯否细胞培养板中,应用MTT比色法检测各组肝星状细胞和枯否细胞的增殖状况,免疫细胞化学检测各组肝星状细胞中α-平滑肌肌动蛋白(α-SMA)、转化生长因子-β1(TGF-β1)、层连蛋白(LN)的表达.结果加入高浓度肝素、低浓度肝素及未用药的肝星状细胞0D值分别为0.0626±0.0137、0.0746±0.0131和0.1106±0.0198.加入高浓度肝素、低浓度肝素及未用药的枯否氏细胞0D值分别为0.1340±0.0270、0.1540±0.270和0.2120±0.0444.二肝素组肝星状细胞、枯否氏细胞0D值均显著低于未加药组.高浓度肝素组肝星状细胞及枯否氏细胞0D值较低浓度肝素组为低,但无显著性差异.加入肝素的肝星状细胞α-SMA、TGF-β1,LN的表达较未用药的肝星状细胞为弱.高浓度肝素组α-SMA、TGF-β1 LN的表达较低浓度肝素组弱.结论肝素可抑制肝星状细胞的增殖、活化及胶原的分泌,且对枯否氏细胞也具有抑制作用.     

高血糖对大鼠肝纤维化及肝星状细胞活化的影响

目的探讨高血糖对大鼠肝纤维化及肝星状细胞活化的影响。方法取大鼠66只,随机分为4组,A组和B组均采用STZ(链脲佐菌素)和CCl4(四氯化碳)诱导为肝纤维化并糖尿病模型。A组诱导成功不做处理。B组糖尿病诊断成立后,皮下注射门冬胰岛素,3次/d控制血糖。C组单纯利用CCl4(四氯化碳分析纯)诱导为肝纤维化模型。D组(空白对照组)常规喂养,不做处理。观察各组大鼠一般情况(包括鼠食消耗、毛发变化、活动指数),8周后处死,测量大鼠体质量、肝脏体积及重量,采集血液及肝脏标本,分析对比各组大鼠肝脏系数,HE染色后光镜下肝组织纤维化情况;免疫组化SP法检测肝组织内α-SMA表达。结果实验各组与对照组大鼠相比体质量明显减轻(P<0.05),肝脏系数明显增加(P<0.05),肝组织α-SMA表达均不同程度增强(P<0.05);其中A组的体质量减轻最明显,肝纤维化、肝脏系数增加最显著(P<0.05),肝组织α-SMA表达亦有显著性差异(P<0.05);B组与C组相比体质量无明显减轻(P>0.05),肝脏系数无明显增加(P>0.05),而肝组织α-SMA表达差异有统计学意义(P<0.05)。结论高血糖可促进大鼠肝纤维化形成及肝星状细胞的活化。     

维药小茴香抗肝纤维化作用及对TGF-β/smad信号转导通路的影响

目的探讨小茴香提取物抗肝纤维化的作用及其对TGF-β/smad信号转导通路和肝星状细胞活化的影响。方法选择44只SD大鼠给予40%四氯化碳(CCl4)橄榄油溶液4 ml/(kg·体重)皮下注射5周制备肝纤维化模型,成模后随机分成治疗组和模型对照组,同时取6只正常大鼠做空白对照。治疗组给予小茴香提取物灌胃,模型对照组给予生理盐水灌胃,4周末处死大鼠检测血清ALT、AST、HA、LN,肝石蜡切片行Masson染色和抗α平滑肌动蛋白(α-SMA)、TGF-β受体Ⅰ型(TGF-βRⅠ)、TGF-β1免疫组织化学染色,反转录实时荧光定量PCR分析肝组织TGF-β1、smad2 mRNA相对内参基因甘油醛-3-磷酸脱氢酶(GAPDH)的表达量。结果小茴香提取物治疗组血清ALT、AST、HA水平,肝组织内胶原纤维含量、α-SMA、TGF-βRⅠ、TGF-β1表达以及TGF-β1、smad2 mRNA相对表达量均明显低于模型对照组。结论小茴香提取物可通过抑制TGF-β/smad信号转导通路抑制肝星状细胞活化,从而减轻大鼠肝纤维化。     

瘦素在肝纤维化组织中的表达及其与肝星状细胞活化的关系

目的:探讨瘦素(leptin)在肝纤维化组织中的表达及其与肝纤维化过程中转化生长因子(TGF-β1)以及α平滑肌肌动蛋白(α-SMA)表达的相关性,了解leptin与肝星状细胞(HSC)活化的关系.方法:健康 SD大鼠40R,随机分成正常对照组和CCl4诱导的肝纤维化模型组.于造模2、4、6 wk末分批处死动物,分别采用RT-PCR和Western blot、免疫组织化学方法联合检测leptin、TGF-α1及α-SMA在肝纤维化组织中的表达.结果:正常对照组肝脏组织中leptin、TGF-β1、α-SMA均有微量表达;CCl4注射2wk后,leptin、TGF-β1、α-SMA表达开始增强,2、4、6 wk肝组织中的表达强度呈明显递增趋势(P<0.05).leptin与TGF-β1和α-SMA表达均呈显著相关性(r=0.668,0.570,均P<0.05).结论:leptin的阳性表达随着肝纤维化程度的加重而增强.在肝纤维化过程中leptin可能参与了HSC活化、增殖以及ECM的合成.     

表达持续活化型ALK3抑制大鼠肝星状细胞活化

背景肝纤维化与肝星状细胞(hepatic stellate cells, HSCs)上皮细胞间充质转化(epithelial mesenchymal transformation, EMT)相关, TGF-β1在其中起着重要的作用,而BMP7能够拮抗TGF-β1,目前主要研究的是TGF-β/BMPs-Smad信号通路, ALK3属于BMPs的持续活化Ⅰ型受体,在肝纤维化分子研究机制中较少运用.目的观察大鼠HSCs中稳定表达持续活化型ALK3时Smad1磷酸化及纤维化相关基因E-cadherin、α-SMA、col1A2等表达情况,探讨BMP-7信号转导在肝纤维化发生发展过程中拮抗TGF-β1信号及其抗肝纤维化机制.方法建立体外培养大鼠HSCs (HSC-T6)持续活化型ALK3的稳定表达细胞株, MTT检测细胞的增殖; RT-PCR检测col1A2等相关分子mRNA水平; Western blotting检测Samd1、E-cadherin、α-SMA、col1A2蛋白表达和Smad1磷酸化;显微镜下观察细胞形态.结果稳定表达持续活化型ALK3的HSC-T6细胞增殖受到抑制, Smad1磷酸化显著升高,α-SMA, col1A2表达下调, E-cadherin表达上调.结论 BMP-7信号转导通过增强Samd1的磷酸化而拮抗TGF-β1致纤维化作用,抑制大鼠HSCs的活化.     

抗纤软肝胶囊对大鼠肝纤维化肝星状细胞活化及凋亡的影响

目的探讨抗纤软肝胶囊对大鼠肝纤维化肝星状细胞(HSC)活化及凋亡的影响。方法将32只清洁级SD大鼠采用随机数字表法分为正常对照组和肝纤维化建模组各16只。建模组大鼠皮下注射四氯化碳(CCl_4)诱导大鼠肝纤维化,正常对照组以同样方法注射等量植物油,随后将正常对照组随机分为正常组8只,药物组8只,建模组随机分为模型组8只,治疗组8只。药物组、治疗组均给予抗纤软肝胶囊治疗,其他组同期灌服相当量的生理盐水。应用苏木素-伊红(HE)染色和Masson染色观察各组肝脏病理组织学改变;检测各组大鼠血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白蛋白(ALB)、透明质酸(HA)、层黏连蛋白(LN)、Ⅳ-C型胶原(Ⅳ-C)及Ⅲ型前胶原(PC-Ⅲ)水平;RT-PCR法或流式细胞术检测各组血清体外对HSC-T6细胞中α平滑肌动蛋白(α-SMA)和转化生长因子(TGF)-β1 mRNA表达以及细胞凋亡水平的影响。结果与模型组大鼠比较,治疗组大鼠肝脏的肝纤维化程度减轻;治疗组血清ALT、AST、HA、LN、IV-C、PC-Ⅲ水平明显低于模型组,而ALB水平明显高于模型组(均P<0.05);体外实验发现药物组及治疗组α-SMA和TGF-β1 mRNA的表达水平显著低于正常组及模型组(均P<0.05)。流式细胞术检测结果显示,药物组及治疗组HSC-T6的凋亡水平显著高于正常组及模型组(均P<0.05)。结论抗纤软肝胶囊通过参与调控HSC的活化及凋亡,可发挥对肝纤维化大鼠的治疗作用。     

α-亚麻酸对转化生长因子β1诱导的肝星状细胞的影响

目的:探讨α-亚麻酸(α-linolenic acid,ALA)对转化生长因子1(transforming growth factor-β,TGF-β1)诱导的肝星状细胞(hepatic satellite cell,HSC)增殖及分泌功能的影响.方法:采用活化的HSC作为研究模型,将传代的细胞分为5组,以MTT比色法观察ALA对HSC的增殖效应,以ELASA检测细胞培养上清液中Ⅰ型及Ⅲ型胶原的含量,以Westernblot法检测α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)的表达.结果:TGF-β1能诱导HSC增殖并促进胶原的分泌,ALA可不同程度抑制TGF-β1所诱导的HSC增殖及Ⅰ、Ⅲ型胶原和α-SMA的表达(P<0.01),且呈剂量依赖性(P<0.05).结论:ALA在高浓度时对TGF-β1能诱导的HSC起抑制作用,可能对脂肪性肝纤维化及其引起的肝硬化有治疗作用.     

姜黄素对肝纤维化大鼠肝组织中NF-κB及ERK-1 mRNA表达的影响

目的 探讨核转录因子-κB(nuclear factor kappa B,NF-κB)及细胞外信号调节激酶(extracegular signal-reglulated kinase,ERK)mRNA在CCl4致实验性肝纤维化大鼠肝组织中的表达及姜黄素(curcumin,CUR)对它们的影响.方法 建立CCl4致大鼠实验性肝纤维化的模型,用免疫组化法比较正常组、模型组及CUR组的α平滑肌肌动蛋白(α-SMA)的表达,用RT-PCR法比较各组肝组织NF-κB及ERK-1 mRNA的表达.结果 模型组中,ERK-1及NF-κB mRNA的表达均增高,而CUR组α平滑肌肌动蛋白则较模型组低,NF-κB及ERK-1 mRNA的表达也降低.结论 CUR可能通过抑制α-SMA的表达,减弱NF-κB诱导的肝星状细胞的活化及抑制ERK-1促肝星状细胞的增殖,从而产生抗四氯化碳诱导的大鼠肝纤维化的作用.     

飞天蜈蚣七对肝纤维化大鼠肝组织转化生长因子β1蛋白表达的影响

目的探讨飞天蜈蚣七防治肝纤维化的作用机制.方法CCl4法复制肝纤维化模型,48只SD大鼠随机分为飞天蜈蚣七组(A组)、秋水仙碱组(B组)、模型组(C组)和正常对照组(D组),每组12只.各组分别在第22、43天时,检测血清透明质酸(HA)、层粘蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)含量;行肝组织转化生长因子-β1(TGF-β1)免疫组化染色,检测其蛋白表达.结果第22天时,与D组、A组比较,C组血清HA、PC-Ⅲ升高,TGF-β1阳性表达较强(P＜0.05),LN升高(P＞0.05);第43天时,与D组比较,C组血清HA、LN、PC-Ⅲ明显降低,肝组织TGF-β1阳性表达明显减轻(P＜0.05).结论飞天蜈蚣七可以减轻肝纤维化程度、抑制肝组织TGF-β1蛋白的表达,飞天蜈蚣七可作为抗肝纤维化的一种有效药物.     

水蛭桃仁汤对肝纤维化大鼠HSC活化及TGF-β1表达的影响

观察水蛭桃仁汤对肝纤维化大鼠肝星状细胞(HSC)活化及转化生长因子β1(TGF-β1)表达的影响,并探讨其对肝纤维化是否具有治疗作用及其作用机制.方法:以二甲基亚硝胺(DMN)制备大鼠肝纤维化模型,同时给予水蛭桃仁汤灌胃治疗.免疫组化法检测肝组织的α-平滑肌动蛋白(α-SMA)和TGF-β1,并做组织病理学检测.结果:经图像分析,药物防治组α-SMA和TGF-β1较模型组显著减少(均为P＜0.01);结论:水蛭桃仁汤对DMN诱导的实验性大鼠肝纤维化具有良好的防治作用.     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El^® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.