缬沙坦对免疫性大鼠肝纤维化的影响

目的研究血管紧张素Ⅰ型(AT1)受体阻断剂对免疫性大鼠肝纤维化的影响。方法采用猪血清诱导建立肝纤维化模型,以大剂量和普通剂量缬沙坦干预,观察肝组织纤维化程度、胶原表达变化;免疫组化染色观察α平滑肌肌动蛋白(αSMA)、转化生长因子β1(TGFβ1)及核因子(NF)κBp65表达情况。结果与模型组比较,治疗组胶原面积显著减少,具有剂量依赖性(P<0.05),纤维化程度也明显改善;模型组αSMA、TGFβ1、NFκBp65表达增强(P<0.05),缬沙坦治疗后,都有不同程度的减弱,模型组和大剂量组αSMA分别为19.68±1.28和8.66±1.72,TGFβ1分别为22.36±4.77和9.95±2.28,NFκBp65分别为30.31±4.16和19.80±1.96(均为面密度值,P<0.05)。结论缬沙坦能明显抑制猪血清诱导的大鼠肝纤维化发生,可能与抑制肝星状细胞活化、增殖,降低TGFβ、NFκBp65等表达有关。     

TGF-β1Ⅱ型受体部分基因表达质粒对实验性大鼠肝纤维化的影响

目的　观察缺陷型TGF β1 Ⅱ型受体表达质粒在大白鼠体内阻断TGF β1 的作用后对免疫性大鼠肝纤维化的影响。方法　运用基因重组技术 ,构建人的含有细胞外结合区、跨膜区和少量细胞质区的缺陷型TGF β1 Ⅱ型受体真核细胞表达质粒 ,经脂质体包埋后 ,通过腹腔注射将其导入免疫性大鼠肝纤维化模型体内 ,观察其对大鼠肝纤维化的影响。结果　早期接受缺陷型TGF β1 Ⅱ型受体表达质粒治疗的大鼠 ,其血清透明质酸 (HA)、层黏连蛋白 (LN)、Ⅲ型前胶原 (PCⅢ )、Ⅳ型胶原 (Ⅳ C)的水平均比模型组低 (P <0 .0 1) ,晚期组与模型组之间差异无显著性 (P >0 .0 5 ) ;在病理形态学的观察方面 ,早期、晚期运用缺陷型TGF β1 Ⅱ型受体表达质粒进行治疗 ,均可使大鼠肝纤维化程度较模型组减轻 (P <0 .0 1)。结论　在肝纤维化形成的早期应用缺陷型TGF β1 Ⅱ型受体表达质粒进行治疗可以预防肝纤维化的形成 ,而晚期应用只能阻止肝纤维化的进一步发展 ,尚不能有效逆转肝纤维化     

氧化苦参碱抗肝纤维化作用的病理学研究

目的　研究氧化苦参碱对实验性大鼠肝纤维化的治疗作用 ,并探讨其作用机理。方法　 80只Wistar大鼠 ,随机挑选72只给予皮下注射 5 0 %四氯化碳及以 10 %酒精替代饮用水 ,其余 8只作为正常对照组 (N组 ) ,8周后造模组中随机处死 16只 (M组 )证实肝纤维化形成 ,剩下肝纤维化大鼠随机分成二组 ,分别给予氧化苦参碱腹腔注射 (T组 ,10 0mg·kg-1·d-1)和生理盐水腹腔注射 (R组 ,10mg·kg-1·d-1) ,疗程为 9周 ,实验结束时全部大鼠采血后处死 ,分别行HE染色评估肝纤维化程度 (采用纤维化半定量计分系统 ,SSS)、免疫组化法检测肝组织中TGFβ1水平、Masson染色法评估肝组织中胶原纤维百分比。 结果　氧化苦参碱组 (T组 )大鼠肝纤维化程度较自然恢复组 (R组 )明显减轻 ( 7.5 4± 2 .2vs10 .44± 3 .0 ,P <0 .0 5 ) ,两组大鼠肝组织中胶原面积密度差异显著( 10 .4± 3 .0vs 16.8± 3 .5 ,P <0 .0 5 ) ;T组血清转氨酶显著高于R组 (P <0 .0 5 ) ,M组大鼠肝组织TGFβ1的表达较N组明显升高( 12 5 .2± 2 2 .7vs 3 0 .5± 9.5 ,P <0 .0 1) ,氧化苦参碱治疗后肝组织TGFβ1明显减少 (P <0 .0 1)。 结论　氧化苦参碱具有明显的逆转肝纤维化作用 ,其机理可能与其降低TGFβ1的表达有关     

氯沙坦抗大鼠肝纤维化的研究

目的 :研究血管紧张素Ⅱ 1型受体拮抗剂氯沙坦对二甲基亚硝胺 (DMN)诱导的肝纤维化大鼠模型的疗效及可能的机制。方法 :制备DMN诱导的大鼠肝纤维化模型 ,同时应用氯沙坦灌胃 ,共 8周。肝组织进行常规HE及Masson三色染色。测定血清肝功能及透明质酸 (HA)。大鼠肝组织Ⅰ型胶原 (ColⅠ )、Ⅲ型胶原 (ColⅢ )及转化生长因子 βl(TGF β1)mRNA的水平用RT PCR方法检测。结果 :氯沙坦可明显改善肝纤维化的程度 ,降低血清ALT及HA的水平 (P <0 .0 1)。同时模型组ColⅠ、ColⅢ及TGF β1mRNA的水平明显高于正常对照组 ,氯沙坦治疗组明显低于模型组 (P <0 .0 0 1)。结论 :氯沙坦具有良好的抗肝纤维化作用 ,且能够抑制肝组织ColⅠ、ColⅢ及TGF β1mRNA的水平 ,从而发挥其抗肝纤维化的作用。     

雌二醇对肝纤维化大鼠Ⅰ,Ⅲ型胶原及TGFβ1表达的影响

目的:观察雌二醇对肝纤维化大鼠肝脏胶原沉积和转化生长因子β_1(TGF β_1)表达的影响,研究雌激素对肝纤维化形成的抑制作用,并探讨其可能的机制。方法:设立模型组、治疗对照组、雌二醇组和正常对照组,以四氯化碳复合因素诱导大鼠肝纤维化动物模型,雌二醇组在四氯化碳应用的同时皮下注射苯甲酸雌二醇1mg/kg,2次/wk,共8wk。大鼠肝脏HE染色与Masson染色,分级观察肝组织的炎性坏死与胶原纤维沉积变化,并观察对大鼠肝纤维化形成过程中肝脏表达Ⅰ,Ⅲ型胶原蛋白及对TGF β_1的影响。结果:与正常对照组比较,四氯化碳模型大鼠出现典型的肝纤维化表现,肝脏胶原纤维间隔广泛形成,肝小叶与肝窦内胶原增生沉积明显,Ⅰ,Ⅲ型胶原(0.58±0.26vs 6.34±2.24,1.07±0.49 vs 5.28±1.28,P值均<0.001)及TGF β_1基因表达明显增多;雌二醇应用可以明显减轻肝脏内胶原纤维增生沉积P<0.05),抑制肝脏Ⅰ、Ⅲ型胶原蛋白(2.47±0.76 vs 6.34±2.24,3.02±1.20 vs5.28±1.28,P值均<0.05)及TGF β_1的合成表达。结论:雌二醇可抑制肝纤维化大鼠肝脏Ⅰ,Ⅲ型胶原蛋白及TGF β_1的合成表达,发挥对肝纤维化的抑制作用。     

肝力克对肝纤维化大鼠肝组织转化生长因子β1 mRNA表达的影响

[目的 ]探讨中药复方肝力克对肝纤维化大鼠肝组织转化生长因子 β1(TGF β1)mRNA表达的影响。 [方法 ]用 4 0 ?l4皮下注射建立SD大鼠肝纤维化模型。造模结束后 ,给予不同剂量的肝力克和秋水仙碱灌胃治疗 9周。采用原位杂交法观察大鼠肝组织中TGF β1mRNA的表达情况。 [结果 ]肝纤维化模型组大鼠肝组织TGF β1mRNA阳性表达较正常对照组明显升高 (P <0 .0 1) ;应用肝力克大、中、小剂量和秋水仙碱治疗后 ,大鼠肝组织TGF β1mRNA阳性表达均较肝纤维化模型组明显降低 (P <0 .0 1,<0 .0 5 )。肝纤维化模型组大鼠肝组织纤维化计分与TGF β1表达程度呈明显正相关 (r =0 .80 1,P <0 .0 1)。 [结论 ]肝纤维化大鼠肝组织TGF β1mRNA表达程度与肝纤维化的发生发展有密切关系 ;中药肝力克降低肝纤维化大鼠肝组织TGF β1mRNA的表达可能是其抗肝纤维化的作用途径之一。     

安体舒通抗肝纤维化作用实验性研究

目的　研究和评估安体舒通对实验性大鼠肝纤维化的防治作用 ,探讨其抗肝纤维化作用的可能机制。结果　将雄性Wistar大鼠 80只随机分为正常对照组 (A组 ,16只 ) ,肝纤维化模型组Ⅰ (B组 ,5 4只 ) ,安体舒通治疗组Ⅰ (C组 ,10只 ) ,采用CCl4 复合因素造模 ,治疗组于造模同时予安体舒通每日 10 0mg·kg-1·mL-1灌胃 ,6周末造模成功处死C组大鼠 ,同时随机处死A组及B组大鼠各 8只 ;对B组剩下大鼠行二次随机分组 ,分为模型对照组Ⅱ (D组 ,12只 ) ,安体舒通治疗组Ⅱ (E组 ,10只 ) ,E组于第 7周开始给予安体舒通治疗 ,10周末处死大鼠。检测大鼠肝功能 ,血清透明质酸 (HA) ,层粘蛋白 (LN) ,Ⅲ型前胶原 (PCⅢ ) ,Ⅳ型胶原 (CIV) ;免疫组化法检测肝组织基质金属蛋白酶组织抑制因子 (TIMP -1)的表达。结果　C组与B组比较 ,血清ALT、AST、HA、LN、CIV、PCⅢ均显著降低 (P <0 .0 1) ,TIMP -1活性明显降低 (0 .34± 0 .0 5vs 0 .45± 0 .0 5 ,P <0 .0 1) .E组与D组相较 ,TIMP -1活性亦有明显降低(0 .31± 0 .0 7vs 0 .42± 0 .0 6,P <0 .0 1)。结论　安体舒通对肝纤维化有一定预防作用 ,并可能通过抑制TIMP -1活性表达而促进肝细胞外基质降解     

银杏叶提取物抗大鼠肝纤维化的实验研究

目的 :探讨银杏叶提取物对实验性大鼠肝纤维化的预防及治疗作用机制。方法 :采用四氯化碳腹腔注射诱导的大鼠肝纤维化模型 ,60只Wistar大鼠分为 5组 :模型组、银杏叶干预组、银杏叶治疗组、银杏叶组 ,另设正常对照组 ,应用HE染色观察大鼠肝组织的改变及Von Gieson胶原纤维特殊染色观察肝纤维化程度 ,生化法检测肝功能丙氨酸氨基转移酶 (ALT)、天冬氨酸氨基转移酶 (AST)、白蛋白 (ALB)水平 ,硫代巴比妥酸 (TBA)法检测肝组织丙二醛 (MDA)的含量 ,免疫组织化学染色法检测肝组织I型胶原、转化生长因子 β1(TGF β1 )的表达。结果 :银杏叶干预及治疗组与模型组相比 ,肝组织结构明显改善 ,纤维化增生程度减轻 ,肝功能改善 ,肝组织内MDA的含量以及I型胶原、TGF β1 的表达均明显低于模型组 (P <0 .0 1 )。结论 :银杏叶提取物可通过其抗氧化作用抑制肝星状细胞激活和转化 ,降低I型胶原、TGF β1 的表达 ,从而抑制和逆转肝纤维化形成     

大鼠肝纤维化病理过程中Smads锚着蛋白表达变化

目的观察肝纤维化病理过程中肝脏Smads锚着蛋白(SARA)的表达变化及其与肝纤维化的关系。方法大鼠每kg体重10μl二甲基亚硝胺腹腔注射,1次/d,每周连续3 d,共4周,复制大鼠肝纤维化模型。模型大鼠分别设首次造模后1、3 d、1,2、3、4周末,与造模停止后1、2、4周,共9个时间段为观察组。每组5～8只,另设正常大鼠10只为对照组。天狼猩红染色观察肝组织胶原沉积,盐酸水解法测定肝组织羟脯氨酸(HYP)含量,免疫组织化学染色观察肝组织SARA蛋白表达,Western blot法分析肝组织转化生长因子(TGF)β1、α-平滑肌肌动蛋白(α-SMA)和SARA蛋白的表达,并进行以上指标的相关性分析。结果随二甲基亚硝胺染毒持续,模型大鼠肝脏胶原增生(Hyp含量)与沉积增加,4周末时达到高峰,可见宽大纤维间隔与假小叶；而后随染毒停止,肝脏胶原沉积与纤维间隔有所减轻。模型组4、5、6、8周肝组织Hyp平均含量(μg/g)分别为193．0±39．2、188．5±39．9．174．4±21．2、163．6±31．5,对照组分别为125．6±19．5,t值在3．43～4．9,P值均＜0．01。免疫组织化学染色发现,SARA主要表达于正常与纤维化肝脏的肝窦周围间质细胞,随肝纤维化发展SARA阳性染色细胞数量减少,随染毒停止与肝纤维化恢复,SARA渐恢复至正常组水平。Western blot发现,随肝纤维化形成,模型大鼠肝组织TGFβ1、α-SMA蛋白表达逐渐增加,而SARA蛋白表达逐渐减少；肝纤维化恢复过程中,SARA渐恢复接近正常水平,TGFβ1与α-SMA蛋白表达有所下降。在肝纤维化形成与恢复过程中,SARA蛋白与Hyp含量、TGFβ1与α-SMA表达均呈明显负相关。结论SARA蛋白主要表达于肝脏间质细胞；随大鼠肝纤维化发展,SARA表达减少,SARA蛋白与肝纤维化形成呈负相关关系。     

肝组织与血清转化生长因子β1表达水平与病毒性肝炎患者肝纤维化的关系

目的 观察肝纤维化不同阶段转化生长因子β_1(TGF β_1)在肝组织内表达情况及血清水平,探讨TGF β_1与肝纤维化发生发展的关系,评价肝脏、血清TGF β_1及血清Ⅲ型胶原(PC Ⅲ)、透明质酸(HA)、层黏连蛋白(LN)、Ⅳ型胶原(C Ⅳ)反映肝纤维化情况。 方法 随机选取92例慢性病毒性肝炎患者,酶联免疫法检测TGF β_1血清水平,其中31例行肝组织活检,做TGF β_1的免疫组织化学染色和胶原纤维染色,并用多媒体彩色图文分析系统对肝脏TGF β_1和胶原进行图像分析定量。 结果 (1)按肝组织纤维化程度(S)分组,除S_2组与S_1组比较外,TGF β_1随纤维化分期加重而表达增加,F=13.46,P<0.05。按炎症活动度级别(G)分组,G_1组、G_2组、G_3组、G_4组之间两两比较差异无显著性。(2)肝组织TGF β_1水平与血清TGF β_1浓度呈正相关(r=0.896)。肝组织TGF β_1水平与肝组织胶原含量呈正相关(r=0.863),肝组织TGF β_1水平与血清PC Ⅲ、HA、LN、C Ⅳ之间均呈正相关,r分别为0.824、0.720、0.747、0.839。 结论 肝脏和血清TGFβ_1表达水平与肝组织纤维化程度密切相关,且较HA、LN、C Ⅳ三项常规指标在反映早期纤维化方面更敏感。     

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.     

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.     

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.     

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.