体外培养破骨细胞的标志酶染色

破骨细胞体外培养是从细胞与分子水平研究骨吸收机理与骨质疏松症防治药物的基础［１］。由于破骨细胞数量少,很难分离到纯的破骨细胞,体外培养所获破骨细胞常与其他细胞混合存在,因此从这些混杂细胞内辨别出破骨细胞尤为重要。鉴别破骨细胞的方法有多种,其中最方便而具特异性的指标为标志酶ＴＲＡＰ与ＴｒＡＴＰａｓｅ染色,作者应用细胞化学方法成功地对体外培养破骨细胞的标志酶进行了染色,报道如下。１　材料和方法１１　动物　出生２４小时内的Ｗｉｓｔａｒ大鼠,本所实验动物房提供,沪医实验动物准字：３４。１２　试剂　Ｍ…     

淫羊藿苷对小鼠破骨细胞β-肌动蛋白、抗酒石酸酸性磷酸酶、核因子-κB受体活化因子mRNA表达的影响

目的观察淫羊藿苷对体外培养小鼠破骨细胞β-肌动蛋白、抗酒石酸酸性磷酸酶（TRAP）、核因子-κB受体活化因子（RANK）mRNA表达的影响。方法用浓度分别为25、30μg/L、1×10^-8mol／L的巨噬细胞集落刺激因子（M-CSF）、核因子-κB受体活化因子配体（RANKL）、1，25（OH）2VitD3体外诱导培养小鼠骨髓源性破骨细胞，分别加入0、1×10^-5mol／L的淫羊藿苷，培养48h后，抽提总RNA，采用半定量逆转录-聚合酶链反应（RT—PCR）方法检测破骨细胞中β肌动蛋白、TRAP、RANKmRNA表达的变化。结果与空白对照组比较，1×10^-5mol／L的淫羊藿苷可明显下调β-肌动蛋白、RANKmRNA的表达（P值均〈0．05），但对TRAPmRNA的表达无明显影响（P〉0．05）。结论淫羊藿可以通过下调β-肌动蛋白、RANK基因表达，从而抑制破骨细胞的分化形成及骨吸收。     

淫羊藿苷通过促进负调控因子Gα13的表达抑制破骨细胞形成

目的 研究淫羊藿苷对破骨细胞分化和鸟嘌呤核苷酸结合蛋白亚基α13(Gα13)介导的信号通路的影响,探讨淫羊藿苷治疗骨质疏松的可能机制。方法 从C57/BL6小鼠四肢骨骨髓中提取原代单核巨噬细胞（bone marrow derived macrophages,BMMs）,使用核因子κB受体活化因子配体（receptor activator of nuclear factor-κB ligand,RANKL）和巨噬细胞集落刺激因子（macrophage colony-stlimulating factor,M-CSF）将BMMs诱导成破骨细胞。同时使用不同浓度（0、1、10μmol/L）的淫羊藿苷进行干预,采用抗酒石酸酸性磷酸酶（TRAP）和鬼笔环肽染色、qPCR和Western blot等实验分析淫羊藿苷对破骨细胞形成及其对Gα13基因和Akt-GSK3β-NFATc1信号通路相关基因表达的影响。结果 TRAP染色和鬼笔环肽染色结果显示淫羊藿苷可显著抑制破骨细胞形成（P<0.05）。淫羊藿苷显著促进Gα13基因及蛋白表达（P<0.05）,显著抑制Akt-GSK3β-NFATc...     

淫羊蕾苷抗骨质疏松研究进展

淫羊藿苷是中草药淫羊藿的主要有效成分之一,近年来对其在细胞水平的抗骨质疏松作用研究日益增多.笔者从骨髓间充质干细胞、成骨细胞和破骨细胞三方面入手,综述了淫羊藿苷抗骨质疏松的研究进展,并提出了今后的研究思路.     

淫羊藿苷对破骨细胞活性的影响

目的:观察淫羊藿苷对破骨细胞骨吸收及凋亡的影响,探讨淫羊藿苷的抗骨质疏松作用机制。方法:体外分离、培养兔破骨细胞,与玻片及骨磨片共同培养,用10-7、10-6、5×10-6、10-5mol/L浓度的淫羊藿苷刺激破骨细胞,倒置相差显微镜下观察活体细胞、HE染色、TRAP染色及骨吸收陷窝甲苯胺蓝染色,鉴定破骨细胞,并进行骨吸收陷窝计数和面积测量,吖啶橙染色观察凋亡破骨细胞所占的比例。结果:与空白对照组比较,10-6、5×10-6、10-5mol/L浓度的淫羊藿苷组破骨细胞凋亡率均明显增高,骨吸收陷窝数目、面积明显减少,随浓度增加抑制作用增强,差异有显著性意义(P<0.05)。结论:淫羊藿苷可诱导破骨细胞凋亡,抑制骨吸收,并随浓度增加抑制作用增强。     

17β-雌二醇对大鼠破骨细胞内钙浓度影响的研究

目的探讨雌激素调节破骨细胞活性机制。方法以Ｃｈａｍｂｅｒ方法加以改良,常规体外培养新生Ｗｉｓｔｅｒ大鼠破骨细胞（Ｏｓｔｅｏｃｌａｓｔ,ＯＣ）。镜下观察细胞形态,测定不同浓度１７β－雌二醇（１７βＥ２）有在钙与无钙溶液中对破骨细胞钙浓度（ＯＣ「Ｃａ＾２＋」ｉ）的影响。结果３０ｍｉｎ后ＯＣ贴壁生长,胞浆伸展。２ｈ后细胞形态为多形性,有片状或丝状伪足,常规生存５２ｈ。１７βＥ２使细胞变小,除去１７βＥ２     

淫羊藿提取物淫羊藿苷在细胞水平防治骨质疏松症的研究概况

随着我国人口老龄化加剧,骨质疏松症的患病率亦显著上升。近年来对传统补肾中药淫羊藿防治骨质疏松症的研究较多,研究发现淫羊藿单体淫羊藿苷具有较强的抗骨质疏松症活性,能够通过调节骨代谢来有效发挥抗骨质疏松的作用。笔者从淫羊藿苷对骨髓间充质干细胞、成骨细胞及破骨细胞的调节作用及相关信号通路来综述淫羊藿苷防治骨质疏松症的研究进展,旨在为淫羊藿苷的实验研究及临床应用提供思路及借鉴。     

淫羊藿苷对小鼠破骨细胞MMP-9、CK mRNA表达的影响

目的观察淫羊藿苷对体外培养小鼠破骨细胞MMP-9、CK mRNA表达的影响。方法用浓度分别为25 ng/ml、30 ng/ml、10-8mol/L的巨噬细胞集落刺激因子(M-CSF)、核因子κB受体活化因子配体(RANKL)、1,25(OH)2VitD3体外诱导培养小鼠骨髓源性破骨细胞,分别加入0 mol/L、10-5mol/L的淫羊藿苷,培养48 h后,抽提总RNA,采用半定量逆转录-聚合酶链反应(RT-PCR)方法检测破骨细胞中基质金属蛋白酶-9(MMP-9)、组织蛋白酶K(CK)mRNA表达的变化。结果与空白对照组比较,10-5mol/L的淫羊藿苷可明显下调MMP9mRNA的表达(P0.05),但对CK mRNA的表达无明显影响(P0.05)。结论淫羊藿可以通过下调MMP-9基因表达,从而抑制破骨细胞的分化形成及骨吸收。     

淫羊藿苷对小鼠骨髓源性破骨细胞诱导生成及骨吸收功能的影响

目的探讨淫羊藿苷对破骨细胞诱导产生及骨吸收功能的影响。方法用终浓度分别为25ng·mL^-1、30ng·mL^-1、10^-8mol·L^-1的M—CSF、RANKL、1，25（OH）2VitD3体外诱导培养小鼠骨髓源性破骨细胞，在此过程中加入终浓度分别为0、10^-7mol·L^-1、10^-6mol·L^-1、10^-5mol·L^-1的淫羊藿苷。倒置相差显微镜下观察活体细胞、HE染色、TRAP染色及降钙素受体染色鉴定破骨细胞，计数骨片上骨吸收陷窝数及面积，玻片上TRAP阳性多核细胞数。结果加药组随淫羊藿苷浓度的增加，骨片上形成的骨吸收陷窝数及面积，玻片上的TRAP阳性多核细胞数呈量的依赖性的减少，与非加药组比较，10^-5mol·L^-1、10^-5mol·L^-1浓度的淫羊藿苷组，差异有显著性（P〈0．05）。结论淫羊藿苷具有抑制破骨细胞诱导产生及骨吸收功能的作用，并随浓度增加抑制作用增强。     

破骨细胞体外培养生存数的观察与鳗鱼降钙素的影响

应用改良的Ｆｅｎｔｏｎ方法由出生２４小时内的新生Ｗｉｓｔａｒ大鼠分离破骨细胞（ＯＣ）培养于盖玻片与骨片上，并应用改良的ＶａｎＤｅＷｉｊｎｇａｅｒｔ和Ｍｏｓｔａｆａ方法对培养在骨片上的ＯＣ进行ＴＲＡＰ染色，观察体外培养ＯＣ的形态与生存时间。培养于骨片上的ＯＣ生存时间可长达２４０小时。１×１０（－９）ｍｏｌ／Ｌ鳗鱼降钙素能明显减少体外培养的多核ＯＣ生存数，但对单核前ＯＣ数没有明显影响     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.