可降解性PDS血管外支架抑制移植静脉内膜增生的动物实验观察

24只新西兰大白兔随机分为对照组和实验组,各12只。对照组单纯行颈外静脉移植,实验组同时移植可降解性聚对二氧环己酮（PDS）血管外支架。术后4周取出移植静脉,测量其内膜、中膜的厚度和面积,检测增殖细胞核抗原（PCNA）．计算细胞增殖率。结果显示,实验组PDS血管外支架与移植静脉壁之间形成了富含毛细血管的新生外膜,移植静脉中膜及内膜厚度、面积皆小于对照组（P均〈0．05）;其细胞增殖率为22％±11％,低于对照组的37％±15％（P〈0．05）。认为可降解性PDS血管外支架具有良好的组织相容性,早期可以明显抑制移植静脉内膜和中膜增生。     

核转录因子NF-κB对血管损伤和新生内膜形成的影响

目的:探讨核转录因子NF-κB对血管平滑肌细胞增殖以及大鼠颈动脉球囊损伤后血管新生内膜的作用。方法:原代培养大鼠胸主动脉血管平滑肌细胞。检测增殖的平滑肌细胞内增殖细胞核抗原(PCNA)和NF-κB水平。制作大鼠血管球囊损伤模型,检测血管新生内膜形成及单核细胞化学趋化因子(MCP-1)、NF-κBp65和细胞外信号调节激酶(ERK2)的表达。结果:增殖的平滑肌细胞PCNA和NF-κBp65蛋白水平表达增加。NF-κBp65反义和诱骗寡核苷酸抑制PCNA表达。大鼠血管球囊损伤后第7天,正义组、诱骗对照组、模型组的内膜面积、中膜面积、内膜/中膜比值达到高峰。反义组、诱骗组和反义诱骗组显著降低内膜与中膜比值(P<0.05)。球囊损伤后3d、5d、7d,MCP-1mRNA和蛋白质水平持续而明显的表达增强,14d后略为降低。反义组、诱骗组、反义诱骗组在各时间点均能减少MCP-1mRNA和蛋白质表达。Western Blot检测显示血管球囊损伤后7d,NF-κBp65、ERK2的蛋白合成达到高峰。反义组、诱骗组、反义诱骗组较模型组、正义组、诱骗对照组各时相点蛋白合成均减弱。结论:增殖的平滑肌细胞NF-κBp65基因表达增加。NF-κB调控PCNA、MCP-1、ERK2的基因表达和蛋白质水平。局部转染NF-κB反义和诱骗寡核苷酸能抑制血管新生内膜的形成。     

伊贝沙坦对血管紧张素Ⅱ诱导血管内皮细胞NF-κB激活与ICAM-1表达的影响

目的：观察血管紧张素Ⅱ1型受体（AT1R）拮抗剂伊贝沙坦（irbesartan,Irb）对血管紧张素Ⅱ（AngⅡ）诱导的体外培养人脐静脉血管内皮细胞（HUVEC）核因子-κB（NF-κB）激活与细胞问粘附分子-1（ICAM-1）表达的影响。方法体外培养的第3～5代HUVEC用于实验。采用免疫组织化学分析检测细胞NF—κB弧单位p65、ICAM—1的表达程度。结果AngⅡ有效激活NF—κB并诱导HUVEC表达ICAM-1增加Irb预先孵胄2h能抑制NF—κB并减轻AngⅡ诱导的HUVEC ICAM-1表达。结论AngⅡ通过激活NF-κB使ICAM-1表达增加损伤血管内皮功能Irb能抑制NF-κB激活降低HUVEC ICAM-1表达,从而保护血管内皮功能,这有可能减轻心血管疾病损伤的进展。     

联合转染P~(21)基因及反义c-fos核酸对自体移植静脉内膜增生的影响

目的探讨联合转染P21基因及反义c-fos核酸对自体移植静脉内膜增生的影响,探索一种理想的血管再狭窄的基因疗法。方法选择20只新西兰家兔,实验组10只,对照组10只,均行自体颈外静脉、颈总动脉移植手术,实验组行腺病毒介导的P21cDNA溶液浸泡和反义c-fos聚核酸凝胶涂布;对照组行空载腺病毒溶液浸泡和凝胶涂布。术后2周取出移植血管,分别行病理学、免疫组织化学检测移植血管内膜厚度,内膜血管平滑肌细胞(VSMC)数及内膜平滑肌细胞增殖细胞核抗原(PCNA)阳性表达情况。结果实验组移植血管内膜厚度、管腔狭窄度及VSMC数均较对照组减少(P<0.01),PCNA阳性表达情况亦较对照组明显减少(P<0.01)。结论联合转染P21基因及反义c-fos核酸可有效地抑制移植静脉内膜增生,是一种有效防治移植静脉再狭窄的基因疗法。     

骨髓间充质干细胞移植对大鼠血管成形术后内膜增生及炎症因子表达的影响

目的探讨大鼠血管成形术后,骨髓间充质干细胞(BMSCs)移植对血管新生内膜增生及炎症因子表达的影响。方法制作大鼠颈动脉球囊损伤模型48只,随即分成对照组和BMSCs组,每组24只。标记的BMSCs移植到大鼠,对照组注射等量的PBS液。术后取血管组织行免疫组织化学染色检测核转录因子-κBp65(NF-κBp65)、α-平滑肌肌动蛋白(α-SMA)及增殖细胞核抗原(PCNA)的表达;HE染色血管组织检测血管形态学变化。术后ELISA检测血清炎症因子的浓度。结果术后14 d,BMSCs组损伤血管局部NF-κBp65、PCNA及α-SMA的表达均较对照组明显减少(P<0.05)。术后28 d,BMSCs组新生内膜面积、新生内膜/中膜面积均较对照组显著减少(P<0.05)。与对照组比较,术后BMSCs组血清TNF-α的浓度明显降低(P<0.01),而IL-10水平显著升高(P<0.01)。结论 BMSCs可发挥免疫调节作用,改善血管炎症反应,抑制血管新生内膜增生。     

雷公藤内酯醇涂层支架对猪冠状动脉内皮结构和再狭窄的影响

目的观察雷公藤内酯醇涂层支架（triptolide）置入猪冠状动脉后,血管内膜增殖过程中NF-κB、ki67表达的变化,探讨该药物支架对血管内皮的影响。方法将8只猪进行冠状动脉支架置入术,将雷公藤内酯醇涂层支架和裸支架组对照,置入前降支、回旋支、右冠脉近端。术后12周处死动物,采用光镜观察内膜增生情况,扫描电镜观察内皮修复情况,免疫组织化学法检测平滑肌细胞NF-κB、ki67表达。结果术后12周,triptolide组血管内膜增生[(内膜厚度（0.12±0.05）mm]、内膜面积[（1.17±0.25）mm2]明显小于对照组[内膜厚度[（0.35±0.11）mm,P<0.01],内膜面积[（1.81±0.36）mm2,P<0.05];电镜显示血管内膜表面的内皮细胞较对照组分布更紧密,排列更整齐,覆盖更完整;药物组NF-κB、ki67表达量显著低于对照组。结论雷公藤内酯醇涂层支架可抑制猪冠状动脉平滑肌细胞增殖,有效控制局部炎性活动,抑制内膜增殖。     

老年黄斑变性脉络膜新生血管膜的增殖活性

目的 研究老年黄斑变性(AMD)脉络膜新生血管膜(CNVM)的增殖活性.方法 22例AMD病人的CNVM,用免疫组化的方法分析增殖细胞核抗原(PCNA)、细胞核因子(NF-κB)、c-fos在CNVM中的表达.结果 活动期CNVM的血管内皮细胞与消退期、静止期CNVM的血管内皮细胞对比,PCNA、NF-κB、c-fos均有较高的表达;在静止期CNVM的血管内皮细胞PCNA、NF-κB、c-fos无表达或表达较少(P＜0.01).消退期CNVM的色素细胞与活动期、静止期CNVM的色素细胞对比,PCNA、NF-κB、c-fos均有较高的表达(P＜0.01).消退期CNVM的巨噬细胞与活动期、静止期CNVM的巨噬细胞对比,PCNA、NF-κB、c-fos均有较高的表达(P＜0.01).静止期CNVM的成纤维细胞与活动期、消退期CNVM的成纤维细胞对比,PCNA、NF-κB、c-fos均有较高的表达(P＜0.01).结论 细胞增殖活性的细胞核内基因PCNA、NF-κB、c-fos的表达与CNVM的病理分期(活动期、消退期、静止期)具有明显的相关性.     

血管内照射、抗血小板药物和他汀类药物联用预防再狭窄的实验研究

目的:观察血管内照射、抗血小板药物—氯吡格雷和他汀类药物—辛伐他汀联合应用对再狭窄的预防作用,分析这几种方法之间是否存在协同作用。方法:采用雄性新西兰白兔,给予高脂、高胆固醇饲料喂养6周后,行髂动脉内膜损伤术复制再狭窄模型。然后随机分成4组:单纯损伤组、照射组、药物组、联合组。在术后2、4和8周3个时相点用免疫组化方法检测血管壁增殖细胞核抗原（PCNA）表达阳性细胞,即增殖细胞;以及核因子κB（NF-κB）和细胞间黏附分子-1（ICAM-1）的表达;用计算机图像分析法观察血管组织形态学的变化,并对免疫组化结果进行定量分析。结果:1.其它3组与单纯损伤组相比:①表示内膜增殖程度的指标:内膜厚度（IT）、内膜/中膜厚度（IT/MT）、内膜面积（IA）、内膜面积/中膜面积（IA/MA）和管腔面积（LA）均显著减少（P<0.05）;②血管壁增殖细胞PCNA及NF-κB、ICAM-1的表达均显著降低（P<0.05）。2.其它3组与联合组相比:①表示内膜增殖程度的指标IT、IT/MT、IA、IA/MA、LA均显著减少（P<0.05）;②血管壁增殖细胞PCNA及NF-κB、ICAM-1的表达均显著降低（P<0.05）。结论:1.抗血小板药物—氯吡格雷和他汀类药物—辛伐他汀联合应用可以防止再狭窄的形成;2.血管内照射可有效地防止血管成形术后再狭窄的形成;3.联合应用血管内照射和辛伐他汀与氯吡格雷进行干预效果更加明显。     

抑制核因子κB对缺血再灌注大鼠心肌组织的保护作用

目的探讨丹参注射液对心肌组织的保护作用及其抑制NF-κB活化的可能机制。方法通过观察NF-κB抑制剂PDTC和丹参注射液处理的缺血再灌注（I/R）大鼠心肌,测定心肌组织MDA、MPO、SOD、NF-κB及ICAM-1、TGFβ1蛋白表达。结果心肌匀浆MDA含量、MPO活力明显高于对照组（P〈0.01）,SOD活性显著低于对照组（P〈0.01）;PDTC和丹参注射液组,MDA含量、MPO活性较I/R组明显减少（P〈0.01）,SOD较I/R组明显恢复（P〈0.01）。I/R组心肌细胞中NF-κBp65与ICAM-1蛋白表达信号显著增强,TGFβ1表达信号减低;在PDTC和丹参注射液组,NF-κBp65与ICAM-1表达水平较IR组明显降低,而TGFβ1呈相反变化。结论丹参注射液能增加I/R大鼠心肌SOD活性,减少脂质过氧化物MDA产生。减弱心肌MPO活力,减轻中性粒细胞对心肌细胞的浸润损害,抑制NF-κB的活化,保护I/R大鼠心肌组织。     

全反式维甲酸对兔颈动脉血管重塑及VEGF表达的影响

目的探讨全反式维甲酸（atRA）对兔颈动脉内皮损伤后内膜增生、VEGF表达的影响及机制。方法新西兰雄性大白兔随机分为6组（n=6）：治疗组（A、B）、对照组（A、B）、假手术组（A、B）。治疗组和对照组给予高脂饮食，手术损伤颈动脉内膜，治疗组给予atRA灌胃，假手术组手术但不损伤内膜。分别于术后7、28d处死A、B组动物，取病变血管进行形态学观察，免疫组化测VEGF、PCNA表达水平。结果对照组术后7d内膜开始增生，28d时内膜增生明显，管腔狭窄，有粥样斑块形成，VEGF、PCNA表达明显增加。治疗组内膜增生较轻，28d时内膜面积及斑块厚度低于对照组（分别为P〈0．001、P〈0．05），VEGF、PCNA阳性表达指数也低于对照组（分别为P〈0．01、P〈0．001）。结论atRA抑制兔颈动脉内皮损伤后VEGF、PCNA的表达，减轻新生内膜增殖及动脉粥样硬化病变形成。     

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.     

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.     

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.     

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.