腺病毒介导的白细胞介素10基因转移对胰岛β细胞凋亡及胰岛素释放的影响

Objective To evaluate the efficacy of adenovirus vector-mediated murine interleukin-10 (mIL-10) gene transfer to rat beta cell-RINm5F cells in vitro and to explore the potential value of gene therapy in type 1 diabetes mellitus. Methods The recombinant adenovirus vector Ad-mIL-10 was constructed and transfected into RINm5F cells (Ad-mIL-10 group). Untransfected RINm5F cells and Ad-eGFP-transfected cells were used as controls. The expression of mIL-10 was examined by RT-PCR and Western blot The levels of IL-10 in supernatant were measured by enzyme-linked immunosorbent assay (ELISA). For a determination of insulin release, the cells were cultured with high glucose ( 16. 7mmol/L) for a 1 -hour co-incubation. Then radioimmunoassay was used to detect the level of insulin in supernatant After induction of IL-1β, the levels of nitric oxide (NO) and nitric oxide synthase ( NOS) were measured, the apoptosis of transfected cells was detected by Hoechst 33258 staining and Fas expression by flow cytometry. Results Both mRNA and protein of Ad-mIL-10 were successfully expressed in RINm5F cells. Expression of mIL-10 gene resulted in significant increases in insulin secretion in response to high glucose. Compared with uninfected control and Ad-eGFP infected group, Ad-mIL-10 infected group had decreased levels of NO and NOS induced by IL-lβ [ NO level ( nmol/106 cells): 52. 9 ± 3. 2 vs 227. 3 ± 26. 4, 235. 1 ±28.6, both P＜0.05; NOS level (U/106 cells): 9. 3 ±1.2 vs 29. 8 ±2.5, 30.5 ±2.8, both P ＜ 0. 05]. Furthermore, Ad-mIL-10 gene transfer led to a profound reduction of Fas-expressing islet cells under the induction of IL-1β. Fas-expressing islet cells in Ad-mIL-10 group were significantly lower than those in uninfected group and Ad-eGFP-transfected group (24. 6% ± 1.0% vs 33. 3% ± 5. 1% , 32. 6% ±1.1%) (P＜0.05).The apoptotic rates of Ad-mIL-10 group were lower in comparison with the other two groups (9.4%±1.1% vs 19.2%±2.2%,20.6%±2.3%,P＜0.05).Conclusions IL-10 gene transfer to islet beta cells may be beneficial in maintaining beta cells function,protecting islet cells from IL-1β-mediated apoptosis and promoting islet cells survival.It is a potential therapy for type 1 diabetes mellitus.     

Protection of human islets from induction of apoptosis and improved islet function with HO-1 gene transduction

Background Islet transplantation represents an ideal therapeutic approach for treatment of type 1 diabetes but islet function and regeneration may be influenced by necrosis or apoptosis induced by oxidative stress and other insults. Heme oxygenase-1 (HO-1) is the rate-limiting enzyme in the catabolism of heme into biliverdin, releasing free iron and carbon monoxide. It has also been reported to be an antioxidant enzyme which can improve the function of grafted islets by cytoprotection via free radical scavenging and apoptosis prevention. In the present study, we investigated whether transduction of HO-1 genes into human islets with an adenovirus vector has cytoprotective action on islets cultured in vitro and discuss this method of gene therapy for clinical islet transplantation.Methods Cadaveric pancreatic islets were isolated and purified in vitro. Transduction efficiency of islets was determined by infecting islets with adenovirus vector containing the enhanced green fluorescent protein gene (Ad-EGFP) at multiplicities of infection (MOI) of 2, 5, 10, or 20. Newly isolated islets were divided into three groups: EGFP group, islets transduced with Ad-EGFP using MOI＝20; HO-1 group, transduced with adenovirus vectors containing the human HO-1 gene using MOI＝20; and control group, mock transduced islets. Insulin release after glucose stimulation of the cell lines was determined by a radioimmunoassay kit and the stimulation index was calculated. Flow cytometry was used to detect apoptotic cells in the HO-1 group and in the control group after induction by recombinant human tumor necrosis factor-α (rTNFα) and cycloheximide (CHX) for 48 hours.Results Adenovirus vectors have a high efficiency of gene transduction into adult islet cells. Transduction of islets with the Ad-EGFP was most successful at MOI 20, at which MOI fluorescence was very intense on day 7 after transduction and EGFP was expressed in cultured islet cells for more than four weeks in vitro. The insulin release in the control group was (182.36±58.96) mIU/L after stimulation by high glucose media (16.7 mmol/L), while insulin release from the HO-1 group and the EGFP group were (270.09±89.37) mIU/L and (175.95±75.05) mIU/L respectively. Compared to the control group and the EGFP group, insulin release in the HO-1 group increased significantly (P＜0.05). After treatment with rTNFα and CHX the apoptotic ratio of islet cells was (63.09±10.86)% in the HO-1 group, significantly lower than (90.86±11.25)% in the control group (P<0.05).Conclusions Transduction of human islets with Ad-HO-1 can protect against TNF-α and CHX mediated cytotoxicity. The HO-1 gene also appears to facilitate insulin release from human islets. Transduction of donor islets with the adenovirus vector containing an HO-1 gene might have potential value in clinical islet transplantation.     

Effect of thoracic epidural blockade on plasma fibrinogen levels in patients with dilated cardiomyopathy

Objective To investigate the effects of thoracic epidural blockade (TEB) on plasma fibrinogen (FIB) levels.Methods Thirty cases of dilated cardiomyopathy (DCM) were selected randomly into a TEB group and a control group. TEB patients were subjected to a persistent TEB (T1－5), and injected with 0.5% lidocaine 3-5 ml every two or four hours for four weeks in addition to routine medicine, while patients in the control group were given routine medicine only. Plasma concentrations of FIB were measured using the micro-capillary assay. Doppler echocardiography was performed before and after the treatment. Results Plasma concentrations of FIB in two groups were greater than the normal value before the treatment. There was a significant decrease of plasma concentrations of FIB in the TEB group after the treatment (4.2±1.3 g/L vs 3.6±0.9 g/L, P<0.05), but there was no significant change in the control group (4.2±1.2 g/L vs 4.3±1.9 g/L, P>0.05). After four weeks of treatment, the left ventricular end diastolic diameters (LVEDD) of TEB patients were reduced (72±10 mm vs 69±10 mm, P<0.05) and the left ventricular ejection fraction (LVEF) of TEB patients increased significantly (33%±13% vs 44%±14%, P<0.05). In contrast, LVEDD (73±11 mm vs 73±12 mm, P>0.05) and LVEF (32%±14% vs 33%±12%, P>0.05) did not change significantly in the control group. Conclusions The results suggest that plasma FIB levels in patients with DCM were decreased by performing a TEB, in addition to a reduction of the enlarged cardiac cavity and an improvement in cardiac systolic dysfunction. TEB might contribute to lowering the occurrence of thrombus and thromboembolism in patients with DCM. TEB might be a promising therapeutic method to improve the prognosis of DCM patients.     

8-甲氧补骨脂素和长波紫外线在细胞光老化中对端粒缩短机制的影响

Objective To investigate the mechanism of telomere shortening through 8-methoxypsoralen(8-MOP)and subsequent ultraviolet A(UVA)irradiation-induced photoaging model in human dermal fibroblasts(HDFs).Methotis Photoaging model was established by 8-MOP+UVA in skin HDFs.Flow cytometer.enzyme eytochemistry,immunofluorescence,Westem blot and Real-time PCR were employed.Results The percentage of G1 blockage of 8-MOP+UVA group were higher than that of control group at 24、48、72 h and 7 d(61.4%±1.5% vs 32.8%±1.5%.69.5%±2.2% vs 44.9% ±2.3%.88.2%±1.6% vs 59.8%±1.4%,90.7%±2.5% vs 68.5%±2.6%.all P＜0.01).The expression of SA-β-Gal of 8-MOP+UVA group were higher than that of control group at 24、48、72 h and 7 d(34.87%±0.59% vs 7.11%±0.78%,59.38%±0.46% vs 10.57%±0.47%.72.46%±0.98% vs 11.67%±0.87%,94.33%±0.13% vs 12.04%±0.12%,all P＜0.01).8-MOP+UVA treatment could significantly aggravate the oxidative DNA damages,the percentage of 8-oxo-dG positive cell of 8-MOP+UVA group(95.78%±0.14%)were significantly higher than that of control group(7.69%±0.09%,P＜0.01),8-MOP group(9.76%±0.11%,P＜0.01)and UVA group(35.29%±0.14%,P＜0.05).8-MOP+UVA treatment could accelerate the telomere shortening.the relative length of telomere of 8-MOP +UVA group were 2.57±0.05 lower than that of control group(6.63±0.12.P＜0.01).The levels of P53,P21WAF-1 and P16INK-4a of 8-MOP+UVA group were higher than that of control group(3.00±0.88 vs 0.54±0.10,2.50±0.51 vs 0.42±0.06,2.21±0.34 vs 0.38±0.05,all P＜0.01).Conclusion 8-MOP+UVA-induced photoaging of HDFs can be mediated though the regulation of telomere and subsequent P53-dependent signaling pathways.     

3T3L1脂肪细胞对大鼠胰岛β细胞功能障碍的影响

Objective To investigate the integrated effects of adipocytes on rat beta-cells, differentiated 3T3L1 adipocytes and rat islet cells co-culture system was established. Methods There were two groups; control group ( SD rat islet cells) and co-culture group (islet cells and 3T3L1 adipocytes co-culture system). Islet cells were obtained for determination of (1) insulin secretion and insulin content; (2) mRNA expressions of GLUT2, GCK and Kir6. 2; (3) protein expressions of IR-β, IRS-1 and their tyrosine phosphorylation leveL Results (1) At low glucose, insulin secretion of co-culture group increased compared with that of control group (0.79±0.35) ng·h-1 · ml-1 islet vs (0.38±0.09 ) ng · h-1 · ml-1 · islet, P = 0. 028 . At high glucose, insulin secretion of those two groups was almost at the same level (P =0.760). Compared with control group (2. 84 ±0.92) , stimulation index (SI, insulin release at high glucose/ low glucose) of co-culture system decreased to (1. 57 ±0. 61, P =0.04). And the insulin content of the both groups was almost at the same level (P=0.102). (2) The mRNA of GCK, GLUT2 and Kir6. 2 in co-culture group downregulated to (0. 27 ±0. 11, P = 0. 01) , (0. 34 ±0. 24, P = 0. 009) and (0.41 ± 0. 09, P = 0. 003) compared with control group (mRNA = 1). ( 3) The protein levels of IR-β, IRS-1 and their tyrosine phosphorylation decreased in co-culture system. Conclusions 3T3L1 adipocytes are involved in beta-cell dysfunction, which may facilitate the development of type 2 diabetes. The effects may be mediated by multiple pathways, which include downregulation of GSIS related gene expressions and suppression of islet cell insulin signaling.     

3T3L1脂肪细胞对大鼠胰岛β细胞功能障碍的影响

Objective To investigate the integrated effects of adipocytes on rat beta-cells, differentiated 3T3L1 adipocytes and rat islet cells co-culture system was established. Methods There were two groups; control group ( SD rat islet cells) and co-culture group (islet cells and 3T3L1 adipocytes co-culture system). Islet cells were obtained for determination of (1) insulin secretion and insulin content; (2) mRNA expressions of GLUT2, GCK and Kir6. 2; (3) protein expressions of IR-β, IRS-1 and their tyrosine phosphorylation leveL Results (1) At low glucose, insulin secretion of co-culture group increased compared with that of control group (0.79±0.35) ng·h-1 · ml-1 islet vs (0.38±0.09 ) ng · h-1 · ml-1 · islet, P = 0. 028 . At high glucose, insulin secretion of those two groups was almost at the same level (P =0.760). Compared with control group (2. 84 ±0.92) , stimulation index (SI, insulin release at high glucose/ low glucose) of co-culture system decreased to (1. 57 ±0. 61, P =0.04). And the insulin content of the both groups was almost at the same level (P=0.102). (2) The mRNA of GCK, GLUT2 and Kir6. 2 in co-culture group downregulated to (0. 27 ±0. 11, P = 0. 01) , (0. 34 ±0. 24, P = 0. 009) and (0.41 ± 0. 09, P = 0. 003) compared with control group (mRNA = 1). ( 3) The protein levels of IR-β, IRS-1 and their tyrosine phosphorylation decreased in co-culture system. Conclusions 3T3L1 adipocytes are involved in beta-cell dysfunction, which may facilitate the development of type 2 diabetes. The effects may be mediated by multiple pathways, which include downregulation of GSIS related gene expressions and suppression of islet cell insulin signaling.     

Establishing an animal model of unstable atherosclerotic plaques

Background Atherosclerotic plaque rupture and coronary thrombosis are the main causes of acute coronary syndromes. However, there is no animal model of unstable atherosclerotic plaques. The presence of the p53 gene in advanced atherosclerotic plaques and the sensitivity to p53-induced apoptosis of smooth muscle cells isolated from these plaques prompted us to build an animal model of unstable atherosclerotic plaques using p53 gene transfer. Methods Sixty-four New Zealand white rabbits were randomly divided into two groups: group A (n=54) and group B (n=10). Rabbits in group A underwent balloon-induced abdominal aortic wall injury and were then given a diet of 1% cholesterol, while rabbits in group B were given a diet of 1% cholesterol without the induction of aortic wall injury. At the end of the eighth week, rabbits in group A were randomly divided into two subgroups: group A1 (n=27) and group A2 (n=27). Recombinant adenovirus carrying p53 or β-galactosidase (LacZ) genes were injected through a catheter into the aortic segments rich in plaques in groups A1 and A2, respectively. Two weeks later, 10 rabbits each from groups A1 and A2 were killed to observe the occurrence of spontaneous plaque ruptures, and the remaining rabbits in groups A1, A2, and B all underwent pharmacological triggering with an injection of Chinese Russell’s viper venom (CRVV) and histamine. Results The over expression of p53 in group A1 ［(32.4±10.2)% vs (15.8±3.6)% in group A2 and (16.2±6.7)% in group B, P<0.001, respectively］ resulted in a marked increase in cellular apoptosis ［(2.5±0.8)% vs (1.0±0.3)% in group A2 and (0.9±0.4)% in group B, P<0.01, respectively］, an accumulation of inflammatory cells within the plaques, and a significant decrease in vascular smooth muscle cells (VSMCs) and in the thickness of the fibrous caps. Although spontaneous plaque rupture was rare in group A1, plaque ruptures and thrombosis occurred in 12 rabbits with a total of 20 lesions after pharmacological triggering. By contrast, pharmacological triggering led to plaque rupture and thrombosis in only 5 rabbits for a total of 7 lesions in group A2 and in none of the rabbits in group B. Conclusion After transfection with human wild-type p53 gene and pharmacological triggering, plaque rupture and thrombosis occur in most atherosclerotic lesions in rabbits, thus offering a reliable model for the further study of unstable atherosclerotic plaques.     

Inhibition of allergic responsiveness in a murine asthma model via IFN-γ transgene expression

Objective To investigate adenoviral vector mediated exogenous gene expression in mouse lungs and the effect of mIFN-γ transgene expression on allergen-induced pulmonary eosinophil infiltration in a murine asthmatic model. Methods LacZ marker gene was transduced into CD-1 mouse airway epithelial cells by installation of a replication-deficient adenovirus with LacZ gene (AdCMVLacZ) 5×10[9]plaque forming unit (pfu) in the intratrachea or nostril.C57 mice were sensitized intraperitoneally and challenged by aerosol with ovalbumin (OVA) to produce an asthmatic model.AdCMVmIFNγ 5×10[9] pfu was administered via nostril in asthmatic mice 48 h before OVA challenge.Sera, bronchial alveolar lavage (BAL) and lungs were recovered 48 h after OVA challenge.Results After administration with AdCMVLacZ by intratracheal installation or nose-drop, the lungs revealed a high level of widespread LacZ transduction with X-gal staining, mainly along airways.IFN-γ via adenoviral vector transduction could be overexpressed both in vitro and in vivo (1624.7±1321.5 pg/ml in BAL 96 h after AdCMVIFNγ infection).In AdCMVIFNγ treated asthmatic models, histological evaluation revealed marked suppression of eosinophil peribronchial and perivascular infiltration; the recoverable percentage of eosinophils in BAL was an average of 9.00%±4.58%, which was a statistically significant decrease versus that of the positive control group (75.13%±6.85%) (P<0.001).The total cell number in BAL ((145±55.6)×10[3 cells/ml) in AdCMVmIFNγ treated mice also was tremendously reduced compared to the positive control group ((216.6±71.1)×10[3 ]cells/ml).Conclusions Adenoviral vector was able to overexpress exogenous gene in murine lungs.IFN-γ overexpression via adenoviral vector in pulmonary epithelia in vivo can abrogate allergen-induced eosinophilic infiltration in lungs in an asthmatic model, which may suggest a new preventively therapeutic method for cytokine immunogenetic transfer in allergic asthma.     

Tongxinluo Ameliorates Myocardial Ischemia-Reperfusion Injury Mainly via Activating Parkin-Mediated Mitophagy and Downregulating Ubiquitin-Proteasome System

Objective: To investigate the protective effects and mechanism of Chinese herbal compound Tongxinluo Capsule (通心络胶囊, TXL) on the Parkin-mediated mitophagy and the ubiquitin-proteasome system in a rat model of myocardial ischemia-reperfusion injury (MIRI). Methods: Seventy adult male Sprague-Dawley rats were randomly divided into 7 groups: sham group, MIRI group, low- and high-dose TXL (0.5 and 1 g?kg-1?d-1, respectively) groups, atorvastatin (ATV) group (7.2 g?kg-1?d-1), chloroquine (CQ) group (10 g?kg-1?d-1), and high dose TXL + CQ group. After pharmacological administration for 7 days, rats underwent left anterior descending artery ligation surgery to establish the MIRI models with 50 min ischemia followed by 4 h reperfusion. Blood was taken for cardiac troponin I (cTnI) detection and hearts were harvested for infarct staining and apoptosis detection. The autophagy or mitophagy proteins and ubiquitinated proteins were detected by Western blotting. Results: Compared with the sham group, the MIRI group exhibited a larger infarcted area (27.13%± 0.01%, P<0.01), a higher apoptotic index (34.33%± 2.03% vs.1.81%± 0.03%, P<0.01), and higher cTnI expression (14.18± 1.01 vs. 7.96± 0.32, P<0.01). The mitochondrial integrity was damaged in the MIRI group, while TXL and ATV alleviated the damage of MIRI. More autophagosomes were observed in the high-dose TXL group than in the MIRI group (7.00± 0.58 vs. 4.33± 1.15, P<0.05). More amounts of PTEN-induced putative kinase protein 1 (PINK1) and Parkin translocated onto the mitochondria were detected in the high-dose TXL group than in the MIRI group (P<0.05). The ubiquitin response was significantly downregulated in the high-dose TXL group relative to the MIRI group (P<0.05). CQ administration abolished the activation of autophagy flux and the PINK1/Parkin pathway induced by high-dose of TXL. Conclusions: TXL ameliorates MIRI via activating Parkin-mediated mitophagy in rats. The downregulation of the ubiquitin-proteasome system is also involved.     

Insulin in endometrial carcinoma chemotherapy: A beneficial addition and not a problem

The effects of insulin or insulin in combination with chemotherapeutic drugs on the proliferation and apoptosis of endometrial carcinoma cells were examined with an aim to determine the efficacy and safety of insulin in endometrial cancer therapy.Ishikawa and Hec-1A cells were treated with insulin and/or paclitaxel.Cell proliferation was assessed by MTT assay.Cell cycle and cell apoptosis were determined by flow cytometry (FCM).Survivin gene expression was detected by RT-PCR.Our results showed that in a certain range of working concentrations and action time, insulin could mildly augment cell proliferation and the percentage of S phase cells in endometrial cancer (Ishikawa/Hec-1A) cells.Insulin plus paclitaxel (combination group) could significantly inhibit cell proliferation (69.38%±2.32% vs 40.31%±4.52% with Ishikawa; 64.11%±6.33% vs 45.89%±3.27% with Hec-1A) and increase cell apoptosis compared with treatment with paclitaxel alone (paclitaxel group).Survivin gene expression was also significantly decreased in combination group as compared with paclitaxel group.We are led to conclude that insulin can mildly augment cell proliferation and present chemotherapy sensitivity in endometrial cancer cells.Insulin can be to used safely and efficiently in endometrial cancer therapy.     

麻疹的双相移位研究进展

近年新生儿、婴儿、成人麻疹患者逐年增加,临床表现一般仍较典型,成年人麻疹患者全身中毒症状较重。麻疹抗体检测结果阳性是主要的诊断依据。麻疹发病的双相移位的机理可能是,免疫保护力不足,婴儿出生时麻疹抗体力低。孕期母传胎的麻疹抗体减弱,母经乳汁传给婴儿的抗体减弱,成人麻疹抗体水平逐年下降。预防措施是怀孕前给予育龄妇女麻疹疫苗接种,鼓励母乳喂养,麻疹疫苗计划免疫适当提前,在成人追加麻疹疫苗的免疫,加强病毒变异的研究等。     

正常增殖期子宫内膜细胞增生状态的定量观察

以＾３氢－胸腺嘧啶核苷放射自显影法及ＨＥ染色，观察并分别测定了１８例正常子宫内膜增殖中期，１５例增殖晚期的腺上皮细胞或间质细胞的标记指数、分裂指数。结果显示：子宫内膜增殖晚期腺上皮细胞或间质细胞之ＬＩ均明显高于增殖中期。同时，增殖晚间质细胞之ＭＩ也明显高于增殖中期，即此两种细胞在增殖晚期中增生明显，其增生状态初步获得了定位定量测定的正常值。     

人工全髋关节置换术的手术配合

目的：介绍人工全髋关节置换术的手术配合做法;方法：主要在手术配合的六个方面,解决防感染、防栓塞等问题。结果：30例人工全髋关节置换术均获成功,结论：手术配合是护士责任心和基本功的全面体现,对提高手术效果有至关重要的影响。     

80例局限性银屑病误诊原因分析

本文报告80例局限于小腿或手或足的银屑病。均经皮肤组织病理检查确诊。因部位比较特殊。受多种理化因素影响,使皮疹形态发生轻重程度不同的变化,常看不到典型损害,因而误诊为神经性皮炎,湿疹,慢性皮炎及癣等。作者对误诊原因进行了分析后,提出了鉴别诊断方法。     

腰椎间盘突出症再次手术的原因分析

目的解决腰椎间盘突出症手术中神经压迫。方法对1980～1998年再手术资料进行统计分析,讨论分析再手术原因,再次手术前影像学检查,观察病理变化以确定再手术方法。结果对11例随访6个月～1年,优7例(68．4％),良3例(36．8％),差1例(2．8％)。结论初次手术前详细查体和分析X线片,术中用导尿管和神经剥离探查,尽量避免髓核遗留,手术范围不宜太大,尽量减少对软组织和脊柱结构的破坏,避免形成硬膜囊与神经根粘连而致单纯形疤痕。     

妊娠晚期重度妊高征的监测

重度妊高征表现为高血压、蛋白尿、浮肿等症状 ,严重可以导致母婴死亡。对妊娠足月的重度妊高征 ,可以根据其临产与否及宫颈条件 ,立即决定其为阴道分娩或是剖宫产术。对于妊娠晚期的重度妊高征 ,因其胎龄不足月 ,胎儿生长发育及胎肺成熟度情况需通过一定时间的治疗 ,根据其病情变化来决定其治疗方案或终止妊娠的时机[1,2 ] 。这就需要我们对这一阶段的治疗进行监测 ,防止母儿并发症的发生。现将 2 0 0 0年至今我院收治妊娠晚期重度妊高征 30例的监测结果回顾分析如下。1　资料和方法1.1　研究对象　选择孕 31～ 36周重度妊高征 30例 ,其中 …     

尿微量白蛋白检测在继发性肾脏疾病中的临床意义

目的探讨尿微量白蛋白（m-Alb）检测在继发性肾脏疾病中的临床意义。方法采用Beckman Immage全自动特种蛋白分析仪对糖尿病组、高血压组、心脏病组患者进行了m-Alb测定,同时与健康组结果作对比。结果m-Alb检测糖尿病组为3.7±5.26mg/dl,高血压组为7.5±8.18mg/dl,心脏病组为7.8±3.76mg/dl,健康组为0.66±0.48mg/dl,各试验组m-Alb增高百分率为糖尿病组48.9%,高血压组37.5%,心脏病组26.9%。结论尿蛋白阴性的糖尿病、高血压、心脏病患者进行m-Alb检测,可以监测病程的进展。