索他洛尔对豚鼠心室肌动作电位及延迟整流钾电流的作用特性

目的　研究索他洛尔对豚鼠乳头状肌动作电位 (AP)和单个心室肌细胞延迟整流钾电流的作用及索他洛尔致心律失常的可能机制。方法　用标准微电极技术和全细胞膜片钳技术 ,分别测定豚鼠乳头状肌AP和单个心室肌细胞离子电流。结果　在索他洛尔浓度为 10 0 μmol/L时可明显延长APD ,使APD2 0 和APD90 分别延长13.33%和 19.71%。且该作用随BCL增加而增加 ,呈现出逆频率依赖性特点。在单个心室肌细胞的实验中10 0 μmol/L索他洛尔仅对IKr有阻滞作用 ,使IKr及IKr,tail的幅值从 (0 .6 8± 0 .2 7) pA/pF和 (0 .94± 0 .30 ) pA/ pF降至(0 .4 7± 0 .18) pA/ pF和 (0 .6 0± 0 .32 )pA/ pF ;且此作用也呈逆频率依赖性。结论　索他洛尔对心肌电生理的逆频率依赖性的作用特性可能是其诱发尖端扭转性室速 (TdP)等心律失常的机制之一。     

BmkTXK β对家兔心房肌细胞钾电流的影响

为研究东亚钳蝎毒素BmkTXKβ对家兔心房肌单细胞电生理特征的影响 ,应用全细胞膜片钳技术记录各项钾电流和动作电位。结果 :BmkTXKβ呈浓度依赖性地延长动作电位时程 (APD2 0 、APD50 和APD90 ) ,但对动作电位幅度 (APA) ,静息膜电位 (RMP)和 0相最大除极速度 (Vmax)无明显影响 (n =9)。在刺激电压 +5 0mV时 1μmol/L的BmkTXKβ使心房肌细胞瞬间外向钾电流 (Ito)从 13.6 3± 0 .87pA/pF减少到 7.98± 0 .78pA/pF ,抑制率为 41.4%(n=10 ,P <0 .0 1)。同时 ,这种作用具有显著的浓度依赖性 ,抑制 5 0 %的电流所需浓度 (IC50 )的均值为 0 .95 μmol/L。BmkTXKβ可抑制延迟整流性钾电流 (IK) ,表现为剂量依赖性阻断的形式。 10 μmol/L时 (刺激电压 +70mV) ,它对IK的抑制率为 39.3 %(从 5 .86± 0 .6 4pA/pF降到 3 .5 6± 0 .5 8pA/pF ,n =6 ,P <0 .0 5 )。IC50 的均值为 2 .76 μmol/L。但BmkTXKβ对内向整流钾电流 (IK1)的电流幅值及其反转电位基本无影响 (n =6 ,P >0 .0 5 )。结论 :BmkTXKβ阻断Ito和IK 等与心脏复极相关的钾离子通道 ,且能在多个环节显著延长APD。     

稳心颗粒甘松提取物对大鼠心室肌细胞钠电流和瞬时外向钾电流激活动力学的影响

目的研究步长稳心颗粒中甘松提取物对大鼠心室肌细胞钠电流(INa)、瞬时外向钾电流(Ito)激活动力学的影响。方法采用全细胞膜片钳技术,研究10 g/L甘松提取物对急性分离的成年大鼠心室肌细胞INa、Ito激活动力学的影响。结果①10 g/L甘松提取物使大鼠心室肌细胞INa峰值(INa,max)从-58.96±2.71 pA/pF降至-31.66±1.29 pA/pF(n=5,P<0.01);②10 g/L甘松提取物使Ito峰值(Ito,max)由3.40±1.52 pA/pF降到1.43±0.64 pA/pF(n=7,P<0.05)。10 g/L甘松提取物对INa和Ito的抑制率分别达38.2%和57.9%。结论10 g/L甘松提取物对大鼠心室肌细胞INa、Ito具有显著抑制作用。     

胺碘酮对模拟缺氧状态下大鼠心室肌细胞瞬时外向和内向整流钾电流的影响

目的通过观察胺碘酮对模拟缺氧状态下急性分离的大鼠心室肌单细胞复极相中瞬时外向钾电流(Ito)和内向整流钾电流(IK1)通道的影响,探讨其在该条件下抗心律失常的作用机制。方法使用酶解法分离获取大鼠单个心室肌细胞,通过持续通以模拟缺氧细胞外液建立体外模拟缺氧模型,采用全细胞膜片钳实验技术研究胺碘酮对该条件下Ito和IK1的作用。结果胺碘酮呈剂量依赖性降低Ito和IK1电流幅值,对Ito抑制效应的起始浓度为1μmol/L,100μmol/L时抑制作用达最大,最大抑制幅度为56.78%±4.27%(23.98±2.18pA/pFvs10.38±4.27pA/pF;测试电压为+70mV;P<0.01;n=5),IC50(半数抑制浓度)为74.35μmol/L,但Ito的I-V曲线趋势并没有发生变化,稳态激活和失活曲线几乎不发生移动。胺碘酮对IK1内向电流部分抑制起始浓度为1μmol/L,外向电流部分抑制效应的起始浓度为2μmol/L,其最大抑制幅度分别为58.77%±10.76%(56.32±7.24pA/pFvs23.22±7.30pA/pF;测试电压为-150mV;P<0.01)和33.29%±2.15%(6.70±0.89pA/pFvs4.46±0.93pA/pF;测试电压为+40mV;P<0.01;n=5)。对内向电流成分的IC50为63.75μmol/L,IK1通道的稳态激活曲线无明显改变。结论在大鼠离体心室肌单细胞模拟缺氧条件下,胺碘酮对Ito和IK1电流幅度呈剂量依赖性抑制,有对抗缺氧本身造成的动作电位时程缩短效应;对I内向电流成分的敏感性高于外向成分。     

自发性高血压大鼠左心室肌细胞动作电位延长的离子机制

目的:研究自发性高血压大鼠(SHR)左心室肌细胞动作电位时程延长的膜离子流基础.方法:应用酶解方法分离获得正常血压Wistar大鼠和SHR的左心室肌细胞,采用玻璃微电极技术记录动作电位,膜片钳全细胞记录膜离子流,对比正常心室肌细胞和肥大心室肌细胞间动作电位及膜离子流差别.结果:(1)SHR和Wistar大鼠的心脏/体重比分别为5.66±0.46 mg/g和3.7±0.29 mg/g (P<0.001) ,细胞平均膜电容分别为280.68±67.98 pF 和189.94±56.59 pF(P<0.05).提示SHR 心脏肥厚、心肌细胞增大;(2)SHR动作电位APD50和APD90较Wistar大鼠明显延长(21.33±1.56 ms vs 14.91±2.95 ms,P<0.001; 164.6±74 ms vs 93.27±10.59 ms,P<0.00 1),说明SHR心室肌细胞存在复极延迟;(3)SHR的平均ICa-L幅值显著大于Wistar大鼠,分别为1944±466.8 pA和1136±33.3 pA(P<0.001),电流密度二者间无差异(6.932±1.7 1 pA/pF vs 6.19±2.85 pA/pF) ,但SHR的慢失活时间常数明显延长(56.01±13.36 ms vs 43.63±17.89 ms,P<0.001);(4)S HR的Ik1内向电流密度显著小于Wistar大鼠(11.3±2.26 pA/pF vs 14.33 pA/pF,P<0.05),外向电流密度二者间差异无显著性(2.36±0.86 pA/pF vs 2.96±1.27 pA/pF);(5)SHR的Ik密度与Wista r大鼠间无差别(12.38±5.46 pA/pF vs 11.86±3.59 pA/pF);(6)SHR的Ito密度显著地低于Wistar 大鼠(+70 mV时, 8.21±6.64 pA/pF vs 19.16±6.17 pA/pF, P<0.001).但通道的激活和失活时间常数二者无差异,提示Ito的降低可能仅是通道数减少所致.结论:SHR左心室肌细胞动作电位时程延长系外向复极钾流(Ito、Ik1)减小和慢钙通道失活时间常数延长所致.     

缬草单萜氧化物对单个兔心室肌细胞钠通道的影响

利用全细胞膜片钳记录技术研究缬草单萜氧化物 (VMO)对兔单个心室肌细胞钠离子电流 (INa)的影响。结果 :30 μg/L和 6 0 μg/L的VMO使兔心室肌细胞INa峰值 (INamax)从 5 3.4 7± 5 .1 3pA/pF分别降至 4 0 .2 5± 4 .1 8pA/pF和 30 .89± 2 .95pA/pF(n =8,P <0 .0 5和P <0 .0 1 ) ,抑制率分别为 2 4 .7%和 4 1 .9% ;VMO使INa的电流 电压曲线上移 ,但不改变其激活电位、电位峰值和反转电位 ;VMO还减慢钠通道灭活后的恢复过程。结论 :VMO对INa具有浓度依赖性阻滞作用 ,这可能是其抗心律失常的重要机制之一。     

奎尼丁对正常大鼠心室肌细胞瞬间外向钾电流的影响

研究大鼠心室肌细胞瞬间外向钾电流(Ito1)的特性及奎尼丁对其的影响,从而从细胞离子的层面去探讨奎尼丁作为治疗Brugada综合征的侯选药物的机制。用酶解法分离大鼠单个左室细胞,应用膜片钳全细胞方法记录Ito1,观察不同浓度的奎尼丁对心室肌细胞Ito1的作用。结果:①大鼠心室肌细胞具有强大的Ito1,在0.2Hz,+70mV和32℃条件下,其平均峰值Ito1强度和密度分别为1940±440pA和12.9±2.6pA/pF;②在奎尼丁1,2.5,5,7.5,10μmol/L不同的浓度下,奎尼丁抑制Ito1程度越明显(自身对照P<0.05),其作用呈浓度依赖性。结论:奎尼丁可以通过抑制Ito1,延长动作电位的复极时程,此很有可能是其作为治疗Brugada综合征的侯选药物的机制之一。     

犬右心室心外膜下细胞瞬间外向钾电流特性的研究

目的　探讨犬右心室心外膜下 (Epi)细胞复极 1期瞬间外向钾电流 (Ito1)的电生理特性。方法　应用全细胞钳制技术 ,对右心室Epi细胞复极 1期Ito1的电流强度、动力学过程和动作电位切迹进行定量观察。结果　 (1)犬右心室Epi细胞具有强大的Ito1,其激活过程呈明显的电压依赖性 ,在37℃、0 2Hz和去极化试验电压为 +70mV时 ,Epi细胞的峰值Ito1强度和密度分别达 (4 15 0± 1780 )pA和 (31± 11 4)pA/pF ,其激活和失活动力学过程符合Boltzmann分布 ;(2 )犬右心室Epi细胞Ito1具有明显的频率依赖性 ,即在基础刺激周长增加时 ,Ito1明显增大 ,并和动作电位的“尖峰 穹隆”幅度的增加相对应 ;(3)温度对Ito1强度的影响明显 ,在去极化试验电压为 +70mV、0 2Hz和温度为 2 2℃、37℃条件下 ,右心室Epi细胞的Ito1强度和密度分别为 (2 380± 10 5 0 )pA与 (18± 7 6 )pA/pF、(4 15 0± 1780 )pA与 (31± 11 4)pA/pF ,差异明显。结论　犬右心室Epi细胞存在强大的Ito1,这种具有明显电压依赖性、频率依赖性和温度依赖性的Ito1及其参与介导的“尖峰 穹隆”状动作电位图形是右心室Epi细胞复极1期一个突出的电生理特点。     

人右心室心外膜下细胞瞬间外向钾电流的初步研究

两例终末期心脏来源于心脏移植的受体病人 ,用酶解分离法获得心外膜下 (Epi)细胞 ,在全细胞钳制条件下观察人右心室Epi细胞瞬间外向钾电流 (Ito1 )的电生理特性。结果发现 :①Epi细胞具有强大的Ito1 ,在 0 .2Hz、+70mV和 37℃条件下 ,Epi细胞的峰值Ito1 离子流强度和密度分别达 1 940± 440pA、1 2 .9± 2 .6pA/pF ;②温度对Ito1 强度的影响明显 ,在 +70mV、0 .2Hz、2 2℃和 37℃条件下 ,Epi细胞峰值Ito1 强度和密度分别为 1 1 90± 31 0pA和 7.7±1 .8pA/pF、1 960± 465pA和 1 3 .1± 2 .8pA/pF ,差异有显著性 (P均 <0 .0 1 ) ;③Epi细胞Ito1 离子流强度表现出明显的频率依赖性 ,在 37℃和 +70mV、刺激频率分别为 0 .2 ,0 .5 ,1和 2Hz时 ,Epi细胞Ito1 离子流强度分别为 1 91 0±42 0 ,1 660± 360 ,1 4 1 0± 2 50 ,830± 1 4 0pA ,差异均有显著性 (P均 <0 .0 1 )。结论 :人右心室Epi细胞存在强大的Ito1 ,此为人右心室Epi细胞复极 1期一个突出的电生理特点 ,可能是Brugada综合征等疾病所致恶性心律失常的重要离子基础之一。     

花生四烯酸乙醇胺对乳鼠心肌细胞外向钾通道电流的影响

目的研究内源性大麻样物质花生四烯酸乙醇胺(AEA)对乳鼠心肌细胞瞬时外向钾电流(Ito)及持续外向钾电流(Isus)的作用。方法体外培养乳鼠心室肌细胞,应用全细胞膜片钳方法检测不同浓度的AEA对Ito及Isus的作用。结果20nmol/LAEA即可显著抑制心肌细胞Ito及Isus的电流密度(分别为16.13±3.31pA/pFvs14.48±1.97pA/pF,及11.17±3.25pA/pFvs10.16±3.21pA/pF;P均<0.01)。逐步增加AEA的浓度至100,500nmol/L及1,5,10μmol/L仍然对Ito及Isus有抑制作用,但对Ito电流密度抑制最多的是5μmol/LAEA,而对Isus电流密度产生最大抑制作用的AEA浓度为1μmol/L。结论AEA对体外培养的乳鼠心肌细胞的Ito及Isus具有抑制作用,这一作用在一定的药物浓度范围内随剂量增加而增加。     

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.