Th1细胞介导急性心肌梗死后心肌IL-6表达的研究

目的探讨介导急性心肌梗死（AMI）后自身免疫应答的淋巴细胞类型。方法体外诱导抗原特异性的辅助性T细胞（Th）分化,将分化成功的Th1、Th2及未活化的T淋巴细胞分别过继转输给同源近交系大鼠（Th1组,Th2组。对照组）。观察受者大鼠的组织病理变化;同时采用RT-PCR和免疫组织化学方法分别检测其心肌组织的白细胞介素（IL-6）mRNA和蛋白表达。结果与对照组相比,Th1组大鼠发生了心肌特异性炎症,淋巴细胞浸润明显;且IL-6mRNA和蛋白表达水平均显著增高（P〈0．01）。结论Th1细胞介导AMI后心肌炎症反应;Th1细胞功能亢进可能是AMI后发生病理性自身免疫应答的重要机制之-。     

T淋巴细胞介导急性心肌梗死后心肌IL-6的表达

目的:探讨心肌梗死后介导自身免疫应答和细胞因子分泌的细胞类型。方法:体外分离同源大鼠T细胞和树突状细胞,与大鼠心肌肌球蛋白共培养,使T细胞活化,然后将活化的、未活化的T细胞分别过继转输给同源大鼠(转输组、对照组),观察3d、1周和4周后心肌的病理改变,分别采用免疫组织化学和RT-PCR的方法检测各时间点白细胞介素-6(IL-6)蛋白和mRNA的表达。结果:转输组大鼠心肌有不同程度地炎性细胞浸润,主要为淋巴细胞,偶见心肌水肿、变性及坏死,炎性细胞浸润以1周最明显,呈弥漫性;对照组大鼠心肌未见类似病理改变。转输组IL-6mRNA和蛋白表达在转输后3d开始升高,1周末达到高峰,4周末开始下降,1周末和4周末心肌组织的IL-6mRNA和蛋白表达均明显高于对照组(P<0·01)。结论:T细胞介导心肌自身免疫性炎症的发生,同时也促使心肌细胞致炎因子IL-6的表达,共同导致急性心肌梗死后心肌细胞的损伤。     

氯沙坦对心肌梗死后左心室肌球蛋白重链基因影响

目的 观察血管紧张素Ⅱ受体阻断药氯沙坦对急性心肌梗死后左心室心肌肌球蛋白重链（myosin heavy chain,MHC）基因表达的影响.方法 Sprague-Dawley大鼠24只随机分为3组,正常对照组,急性心肌梗死组,氯沙坦急性心肌梗死组,每组8只.急性心肌梗死造模后第2日开始灌胃给药,口服氯沙坦日剂量3 mg/kg,6周后测量左心室重量、进行心肌肌球蛋白重链基因分析.结果 急性心肌梗死组大鼠心脏重量指数明显增加,氯沙坦治疗后心脏重量指数明显下降（P＜0.01）;Northern plot发现,急性心肌梗死组大鼠心肌细胞的α-MHC mRNA表达量明显下降,而β-MHC mRNA的表达量则显著上升;而氯沙坦治疗组大鼠心肌的α-MHC mRNA表达较急性心肌梗死组增加,α-MHC mRNA表达明显降低（P＜0.01）.结论 氯沙坦能减轻梗死心肌肥厚,改善梗死心肌心室重构,机制与其调节心肌MHC的基因表达有关.     

过继转输心肌梗死大鼠T淋巴细胞介导心肌重塑的研究

目的探讨T淋巴细胞介导的自身免疫反应在急性心肌梗死(AMI)后心肌重塑中的作用。方法建立大鼠AMI模型和假手术对照模型,术后6周处死,将两组大鼠脾脏T淋巴细胞分别过继转输给同源近交系大鼠。转输后1、6、24周观察受者大鼠的组织病理变化;RT-PCR法检测心肌肌球蛋白重链α、β(α、β-MHC)mRNA表达;并行心脏超声心动图检查。结果转输AMI大鼠脾脏T细胞的大鼠发生了心肌特异性炎症,组织病理显示转输后1周心脏炎症反应明显;中晚期α-MHCmRNA表达减弱,β-MHCmRNA表达增多。假手术组心脏无明显改变。超声心动图示两组大鼠心功能均无明显变化。结论过继转输AMI后T淋巴细胞大鼠发生了心肌特异性炎症和损伤,晚期发生心肌重塑;T淋巴细胞介导的自身免疫反应可能是AMI后心肌重塑的新机制。     

环磷酰胺诱导小鼠对肌球蛋白免疫耐受的初步研究

目的 :应用环磷酰胺诱导小鼠对心肌肌球蛋白免疫耐受 ,探索免疫耐受在心肌炎和扩张型心肌病治疗中的作用。方法 :实验组 ( n =2 0 )于实验第 1,14和 2 8天 3次以猪心肌球蛋白免疫 ,于第1次免疫 2 4h后腹腔注射环磷酰胺 2 2 0 mg/ kg;对照组 ( n =2 0 )按同样方法免疫 ,第 1次免疫 2 4h后以等体积生理盐水代替环磷酰胺腹腔注射。第 35天采集小鼠血清和取心脏标本 ,EL ISA法检测小鼠血清中抗肌球蛋白抗体 ,显微镜下观察心肌病变。结果 :实验组未检测出抗肌球蛋白抗体 ,对照组17例抗体阳性 ,阳性率 85 .5 %。病理结果显示对照组小鼠可见明显炎症病灶 :血管周围炎及心肌间质淋巴细胞、单核细胞浸润。实验组小鼠未见以上病变。结论 :肌球蛋白可以引起小鼠免疫反应及心脏炎性改变 ;环磷酰胺可诱导小鼠对肌球蛋白产生免疫耐受 ,防止心肌损伤。     

合成肽在检测血清抗心肌肌球蛋白抗体中的应用

心肌肌球蛋白是心肌的结构蛋白，具有组织特异性。近年来的研究证实，病毒性心肌炎(VMC)患儿血清中存在抗心肌肌球蛋白抗体。但天然心肌抗原不易获得，且难以长期保存，给临床应用带来一定困难。1999～2002年，我们从肌球蛋白重链的氨基酸序列中选择抗原决定簇片段合成多肽作为抗原，以酶联免疫吸附(ELISA)法检测了48例VMC患儿血清中的抗心肌肌球蛋白抗体，取得满意效果。现报告如下。     

小儿心肌疾病抗肌球蛋白抗体和粒细胞-巨噬细胞集落刺激因子的研究

为探讨病毒性心肌炎（VMC）和扩张型心肌病（DCM）发病的自身免疫机制，采用酶联免疫吸附和放射免疫技术检测30例VMC、14例DCM患儿血浆中抗肌球蛋白抗体和粒细胞-巨噬细胞集落刺激因子（GM－CSF）。结果：VMC和DCM患儿抗肌球蛋白抗体和GM－CSF的阳性率均为54．5％（24／44），而正常对照组分别为4．0％（1／25）和8．0％（2／25）（均P＜0．01），且抗肌球蛋白抗体与GM－CSF的血浆水平有正相关性（r＝0．3583，P＜0．05）。提示：抗肌球蛋白抗体和GM－CSF均参与了VMC和DCM的发病，与心肌的自身免疫损伤过程有关。     

经冠状动脉注射法移植成年犬自体骨骼肌成肌细胞于急性心肌梗死区的病理研究

目的观察冠状动脉内注射法移植自体骨骼肌成肌细胞到无再灌注急性心肌梗死区后的生长分化特点。方法结扎犬冠状动脉前降支中段,建立急性心肌梗死模型;杂种成年犬10只,分为对照组和经冠状动脉注射移植组,各5只。经梗死相关冠状动脉内注射自体骨骼肌成肌细胞悬液10 ml(1.0~1.4×108个)或等量生理盐水;4周后通过HE染色、PTH染色、骨骼肌特异性慢肌球蛋白抗体免疫组织化学染色和透射电镜评价移植细胞病理转归。结果经冠状动脉内注射移植自体骨骼肌成肌细胞4周后,透射电镜及HE染色下可在梗死区内找到新生幼稚肌源性细胞存在,PTH染色证实有新生的横纹肌组织形成,骨骼肌特异性慢肌球蛋白抗体免疫组织化学染色发现有骨骼肌源性的成熟肌组织存在且新生肌组织排列较分散。结论通过经梗死相关冠状动脉注射将自体骨骼肌成肌细胞移植到急性心肌梗死区后能形成成熟的肌组织。     

心肌内注射bFGF对糖尿病合并急性心肌梗死大鼠左室功能、肌球蛋白重链基因表达的影响

目的观察心肌内注射碱性成纤维细胞生长因子（bFGF）对糖尿病合并急性心肌梗死（AMI）大鼠左室功能、肌球蛋白重链（α、β-MHC）、mRNA表达的影响。方法用GK大鼠和Wistar大鼠建立前壁AMI模型后,将GK大鼠随机分为模型组（n=12）和治疗组（n=13）,模型组于心肌内注射生理盐水3ml,治疗组于心肌内注射bFGF6mg＋生理盐水共3ml;Wistar大鼠为对照组,行心脏假手术后于心肌内注射生理盐水3ml。饲养至3周后行血流动力学、左室心肌α、β-MHCmRNA测定。结果模型组左室舒张末压（LVEDP）、pMHCmRNA明显高于对照组,α-MHCmRNA显著低于对照组。治疗组LVEDP、β-MHCmRNA明显低于模型组,α-MHC mRNA显著高于模型组。结论心肌内注射bFGF能提高DM合并心肌梗死大鼠左室功能,逆转心室重塑过程中心肌肌球蛋白重链基因表型改变,延缓心脏衰竭的发展。     

急性心肌梗死大鼠心脏一氧化氮合酶表达的改变

目的 通过建立大鼠心肌梗死模型，观察急性心肌梗死对大鼠心脏内皮型一氧化氮合酶mRNA和诱导型一氧化氮合酶蛋白表达的影响。方法48只健康成年SD大鼠（体重200～250g）随机分为假手术组和缺血组，取1、2、8和24h四个不同时间点观察。采用开胸结扎冠状动脉左前降支建立心肌缺血模型，逆转录聚合酶链反应检测大鼠心肌梗死后1、2及24h三个时段缺血心肌内皮型一氧化氮合酶mRNA的表达；免疫组织化学染色检测冠状动脉结扎后8h缺血心肌诱导型一氧化氮合酶蛋白的表达。结果冠状动脉结扎后2h，缺血组大鼠缺血心肌组织内皮型一氧化氮合酶mRNA表达下降（P〈0．05），并持续至结扎后24h；结扎后24h组内皮型一氧化氮mRNA的表达与结扎后2h组相比无显著性差异（P〉0．05）。冠状动脉结扎后8h，梗死区存活心肌组织细胞诱导型一氧化氮合酶蛋白大量表达，而假手术组未见诱导型一氧化氮合酶蛋白表达。结论正常大鼠心肌组织有内皮型一氧化氮合酶基因表达，无诱导型一氧化氮合酶蛋白表达。在心肌梗死早期缺血心肌内皮型一氧化氮合酶mRNA表达减少。心肌急性缺血刺激早期诱导大鼠缺血心肌组织诱导型一氧化氮合酶蛋白大量表达。     

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.