阿托伐他汀对心肌肥厚大鼠细胞外基质重塑的抑制作用

目的探讨阿托伐他汀对去甲肾上腺素诱导的心肌肥厚大鼠细胞外基质重塑的影响及其可能的机制.方法雄性SD大鼠随机分为三组(1)对照组,(2)去甲肾上腺素组[1.06 mg/(kg·d)×15 d],(3) 去甲肾上腺素+阿托伐他汀组[50 mg/(kg·d)×15 d].去甲肾上腺素ip,2次/d,15 d,建立心肌肥厚模型.应用超声心动图及病理学方法评价整体心肌肥厚及组织胶原表达.用逆转录-聚合酶链反应法(RT-PCR)及免疫组化检测细胞外基质调节因子-基质金属蛋白酶(MMP-9)及其生理性抑制剂(TIMP-1)和转化生长因子β1(TGF-β1)mRNA和蛋白表达.结果去甲肾上腺素组大鼠发生左心室肥厚及纤维化,胶原含量及MMP-9、TIMP-1和TGF-β-1蛋白、mRNA表达显著高于健康对照组(P<0.01).阿托伐他汀能减少心肌中总体胶原及Ⅰ、Ⅲ型胶原的合成及MMP-9、TGF-β-1表达(P<0.01).结论 MMP-9、TIMP-1和TGF-β-1与心肌肥厚大鼠的细胞外基质重塑有关.阿托伐他汀能有效防治心肌纤维化及细胞外基质重塑,这一效应与其降低心肌中高表达的MMP-9和TGF-β-1有关.     

心肌肥厚大鼠超声背向散射积分与细胞外基质重塑的相关性

目的　探讨心肌肥厚大鼠背向散射积分的变化情况 ,并结合心肌细胞外基质的病理改变及其重要影响因子基质金属蛋白酶 (MMP 9)和其生理性抑制剂 (TIMP 1)在蛋白和基因水平的表达 ,探讨其相互关系。方法　SD大鼠腹腔注射去甲肾上腺素 ( 1 0 6mg/kg·d× 15d)建立心肌肥厚的动物模型 ,测定室间隔中部心肌的背向散射参数 ,并应用免疫组化和逆转录 -聚合酶链反应法 (RT PCR)方法检测心肌总体胶原、Ⅰ型和Ⅲ型胶原的改变 ,及MMP 9、TIMP 1蛋白和mRNA的表达 ,与超声测定的结果进行对比研究。结果　 ( 1)实验组大鼠心肌胶原成分及MMP 9、TIMP 1蛋白和mR NA的表达显著高于健康对照组 (P <0 0 1)。 ( 2 )超声背向散射积分 (IBS % )在实验组较对照组增高(P <0 0 1) ,与心肌胶原、MMP 9和TIMP 1蛋白和mRNA的表达之间存在相关性。结论　大鼠心肌肥厚时IBS %升高与胶原的过渡沉积密切相关 ,而MMP 9和TIMP 1可能是引起心肌细胞外基质重塑的重要机制之一。     

基质金属蛋白酶在心肌肥厚大鼠中的作用及强力霉素的干预效果

目的:观察心肌肥厚大鼠模型中基质金属蛋白酶(MMP)-2,MMP-9及其抑制剂(TIMP-1)的表达及强力霉素干预后对其影响。方法:24只大鼠随机分为对照组(A组,只给予0.9%氯化钠溶液腹腔注射);造模组(B组)和药物干预组(C组)均用去甲肾上腺素1.06mg/kg腹腔注射,bid,注射15d,建立大鼠心肌肥厚模型,C组造模同时给予强力霉素10mg/kg腹腔注射,qd,给药15d。全部动物于给药后16d处死测定全心质量指数、左室质量指数、心肌胶原含量、心肌组织MMP-2,MMP-9,TIMP-1、心肌胶原容积分数(CVF)。结果:与A组比较,B组全心质量指数、左室质量指数、MMP-2、MMP-9阳性表达率、心肌胶原含量及CVF均明显增加(P<0.05),TIMP-1阳性表达率明显降低(P<0.05)。与B组比较,C组全心质量指数、左室质量指数、MMP-2、MMP-9阳性表达率、心肌胶原含量及CVF均明显降低(P<0.05),TIMP-1阳性表达率增加(P<0.05)。结论:去甲肾上腺素诱导的心肌肥厚大鼠MMPs/TIMPs系统平衡破坏,使基质胶原降解与合成平衡破坏,从而导致心室重构。强力霉素可通过抑制MMP来逆转心室重构。     

阿托伐他汀对急性冠状动脉综合征患者血清MMP-9及TIMP-1水平的影响

目的 :测定急性冠状动脉综合征 (ACS)患者经阿托伐他汀治疗前后血清明胶酶B(MMP 9)、基质金属蛋白酶组织抑制因子 1 (TIMP 1 )水平 ,探讨两者水平与粥样斑块破裂的关系及他汀类调脂药物稳定斑块的可能机制。方法 :选择稳定型心绞痛 (SAP)患者 3 0例 ,ACS患者 5 4例 ,并选择 3 0例健康人作为对照。随机将ACS患者分成阿托伐他汀治疗组 ( 3 0例 )及常规治疗组 ( 2 4例 ) ,比较各组患者血清MMP 9,TIMP 1水平变化。结果 :SAP、ACS、健康对照组三组之间MMP、TIMP 1水平比较差异有统计学意义 ,阿托伐他汀治疗组与常规治疗组治疗后血清MMP 9、TIMP 1水平相比差异有统计学意义。结论 :血清MMP 9升高及TIMP 1降低与粥样斑块破裂明显相关。阿托伐他汀可降低ACS患者血清MMP 9水平 ,升高TIMP 1水平 ,从而起到稳定斑块的作用     

己酮可可碱对心肌肥厚大鼠基质金属蛋白酶2和9表达的影响

目的观察基质金属蛋白酶2和9在心肌肥厚大鼠模型中的变化,并采用己酮可可碱进行干预,以确定己酮可可碱对基质金属蛋白酶的影响及其在心肌肥厚过程中的作用。方法24只雄性SD大鼠随机分为对照组、去甲肾上腺素造模组(模型组)和去甲肾上腺素 己酮可可碱组(治疗组)。采用VG染色评价组织胶原表达,并测定心肌组织胶原含量,免疫组织化学法检测心肌组织基质金属蛋白酶2和9的蛋白表达。结果模型组大鼠发生左心室肥厚,胶原含量显著高于对照组(1.929±0.514mg/g比1.009±0.442mg/g,P<0.01);基质金属蛋白酶2和9表达(分别为131.1±9.8、125.3±4.1)显著低于对照组(P<0.01)。己酮可可碱治疗组心肌总胶原含量较模型组显著降低(1.151±0.215mg/g,P<0.01);基质中基质金属蛋白酶2和9的表达(分别为153.5±6.9、149.5±5.3)较模型组显著增高(P<0.01)。结论己酮可可碱能有效防治心肌肥厚的发生及细胞外基质重塑,这一效应可能与其降低心肌组织中基质金属蛋白酶2和9的高表达有关。     

心肌肥厚大鼠超声背向散射积分与细胞外基质重塑的相关性

目的探讨心肌肥厚大鼠背向散射积分的变化情况,并结合心肌细胞外基质的病理改变及其重要影响因子基质金属蛋白酶(MMP-9)和其生理性抑制剂(TIMP-1)在蛋白和基因水平的表达,探讨其相互关系.方法 SD大鼠腹腔注射去甲肾上腺素(1.06 mg/kg*d×15 d)建立心肌肥厚的动物模型,测定室间隔中部心肌的背向散射参数,并应用免疫组化和逆转录-聚合酶链反应法(RT-PCR)方法检测心肌总体胶原、Ⅰ型和Ⅲ型胶原的改变,及MMP-9、TIMP-1蛋白和mRNA的表达,与超声测定的结果进行对比研究.结果 (1)实验组大鼠心肌胶原成分及MMP-9、TIMP-1蛋白和mRNA的表达显著高于健康对照组(P<0.01).(2)超声背向散射积分(IBS%)在实验组较对照组增高(P<0.01),与心肌胶原、MMP-9和TIMP-1蛋白和mRNA的表达之间存在相关性.结论大鼠心肌肥厚时IBS%升高与胶原的过渡沉积密切相关,而MMP-9和TIMP-1可能是引起心肌细胞外基质重塑的重要机制之一.     

阿托伐他汀抑制大鼠心肌肥大的实验研究

目的 通过体外心肌细胞培养和在体动物实验方法，观察阿托伐他汀对大鼠心肌肥大的抑制作用，以及对心肌中炎性细胞因子的影响，探讨该类药物影响心肌肥大可能涉及的作用机制。方法 体外原代培养新生大鼠的心肌细胞，以血管紧张素Ⅱ刺激建立心肌肥大模型，给予不同浓度的阿托伐他汀处理。采用RT-PCR法检测脑钠素（BNP）、基质金属蛋白酶9（MMP9）和白细胞介素1β（IL-1β）mRNA的表达，并以^3H-亮氨酸掺入测定心肌细胞蛋白合成速率。在体实验中通过不完全结扎大鼠的腹主动脉，使压力过度负荷增加造成左心室肥厚，以阿托伐他汀治疗4周，RT-PCR检测IL-1β，心调理素-1（CT-1）的表达，并观察心脏的病理学改变。结果心肌细胞肥大模型出现后，心肌细胞的BNP、MMP9和IL-1βmRNA的表达以及蛋白合成速率增加。经不同浓度的阿托伐他汀处理后，这些变化得以减轻。阿托伐他汀抑制压力负荷升高引起的左心室心肌BNP，IL-1β，CT-1的mRNA表达的增加，并减轻大鼠心脏重／体重比值、左心室壁厚度和心肌细胞平均直径的增加。结论 阿托伐他汀可能通过抗炎作用抑制大鼠心肌肥大，对防治以心肌肥厚为特征的心血管疾病可能有一定的应用前景。     

阿托伐他汀逆转腹主动脉缩窄型高血压大鼠心肌重构的机制

目的 观察阿托伐他汀对腹主动脉缩窄型高血压大鼠血清血管紧张素(1-7)浓度及左心室肥厚心肌组织中p-ERK1/2表达水平的影响,探讨阿托伐他汀逆转心肌重构的可能机制.方法 50只SD雄性大鼠随机分为5组:假手术组、模型组、10 mg/(kg·d)阿托伐他汀组、30 mg/(kg·d)阿托伐他汀组及缬沙坦组,每组10只.术后第1天,将阿托伐他汀研磨成粉,溶于少量蒸馏水中制成悬液,采用灌胃法给药;假手术组和模型组大鼠均用等量生理盐水灌胃.每日上午定时一次,共4周.鼠尾容积法测定药物干预前及干预后2周、4周的血压变化.4周后处死大鼠,测定大鼠体重、左心室重量、左心室重量指数;HE染色检测心肌细胞平均直径;酶联免疫吸附法测定血清血管紧张素(1-7)浓度;免疫印迹法检测心肌p-ERK1/2蛋白表达水平.结果 30 mg/(kg·d)阿托伐他汀组和10 mg/(kg·d)阿托伐他汀组收缩压明显低于模型组(P<0.01),30 mg/(kg·d)阿托伐他汀组收缩压明显低于10mg/(kg·d)阿托伐他汀组(P<0.01),缬沙坦组收缩压明显低于30 mg/(kg·d)阿托伐他汀组和10 ms/(kg·d)阿托伐他汀组(P<0.01);假手术组、30 mg/(kg·d)阿托伐他汀组、10 mg/(kg·d)阿托伐他汀组及缬沙坦组左心室重量指数明显低于模型组(P<0.01),30 mg/(kg·d)阿托伐他汀组左心室重量指数明显低于10 mg/(kg·d)阿托伐他汀组(P<0.05);假手术组、30 mg/(kg·d)阿托伐他汀组及缬沙坦组心肌细胞平均直径明显低于模型组(P<0.01).10 mg(kg·d)阿托伐他汀组与模型组无差异(P>0.05);10 mg/(kg·d)阿托伐他汀组、30 mg/(kg·d)阿托伐他汀组及缬沙坦组血清Ang-(1-7)浓度显著高于模型组(P<0.01),30 mg/(kg·d)阿托伐他汀组及缬沙坦组血清Ang.(1-7)浓度明显高于10 mg/(kg·d)阿托伐他汀组(P<0.05);10 mg/(kg·d)阿托伐他汀组、30mg/(kg·d)阿托伐他汀组及缬沙坦组p-ERK1/2蛋白表达水平显著低于模型组(P<0.01),但高于假手术组.结论 阿托伐他汀对腹主动脉缩窄型高血压大鼠心肌重构具有逆转作用,其机制与降低压力负荷诱导的心肌肥厚组织中p-ERK1/2 蛋白表述水平有关.     

酚妥拉明对心肌重构大鼠心肌细胞外基质的影响

目的　探讨酚妥拉明对去甲肾上腺素诱导大鼠心肌肥厚心肌细胞外基质（ECM）重塑的影响及可能机制。方法　24只雄性SD大鼠随机分为对照组、去甲肾上腺素造模组（模型组）和去甲肾上腺素＋酚妥拉明组（治疗组）。采用超声心动图观察心脏结构及功能变化,测定胶原容积积分（CVF）、羟脯氨酸、心肌胶原含量,用免疫组织化学法检测心肌组织基质金属蛋白酶2和胶原蛋白Ⅰ的蛋白表达。结果　模型组大鼠发生左心室肥厚,其羟脯氨酸含量、CVF值显著高于对照组（P＜0.01）,基质金属蛋白酶2和胶原蛋白Ⅰ蛋白表达上调（P＜0.01）。治疗组心肌肥大明显改善,羟脯氨酸、CVF降低,基质金属蛋白酶2和胶原蛋白Ⅰ蛋白表达下降（P＜0.05）。结论　酚妥拉明可有效减轻SD大鼠心肌肥厚的发生及ECM重塑;酚妥拉明缓解ECM重塑可能与其降低心肌组织中基质金属蛋白酶2和胶原蛋白Ⅰ的表达有关。     

MMP-9与TGF-β1在肾性高血压大鼠心肌纤维化中的作用及阿托伐他汀的干预研究

目的探讨基质金属蛋白酶-9(MMP-9)和转化生长因子-β1(TGF-β1)在心肌纤维化中的作用及阿托伐他汀的干预研究。方法采用两肾一夹方法建立肾性高血压大鼠模型,将24只大鼠随机分为对照组、高血压组、阿托伐他汀组,每组8只。术后测量左心室重量指数(LVMI),检测心肌羟脯氨酸(HC)浓度,苦味酸-酸性品红(VG)染色检测心肌胶原容积分数(CVF),免疫组化法检测MMP-9与TGF-β1的表达水平。结果高血压组LVMI、HC、CVF与对照组比较均显著升高(P<0.01),MMP-9与TGF-β1的表达水平显著增强(P<0.01)。阿托伐他汀组较高血压组LVMI、HC、CVF均明显降低(P<0.05),MMP-9与TGF-β1的表达水平亦明显减弱(P<0.01)。结论MMP-9与TGF-β1可能与心肌纤维化的形成有关,阿托伐他汀可以抑制大鼠心肌纤维化的形成,其机制可能与降低MMP-9与TGF-β1的表达水平密切相关。     

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.