黄芪对高糖环境下人脐静脉内皮细胞增殖及血管内皮细胞生长因子表达的影响研究

目的探讨黄芪对人脐静脉内皮细胞（VEC-304）增殖及血管内皮细胞生长因子（VEGF）表达的影响。方法以不同浓度的葡萄糖、黄芪、不同浓度黄芪联合24hIC50葡萄糖作用于VEC-304 24h,观察细胞生长状态变化。MTT法检测细胞生长率。应用RT-PCR检测24hIC50葡萄糖组、黄芪联合24hIC50葡萄糖组VEGF的mRNA表达;Western blot检测葡萄糖组、黄芪组和黄芪联合24hIC50葡萄糖组VEGF蛋白水平。结果 （1）不同浓度的葡萄糖和低浓度黄芪（50mg/L）联合24hIC50葡萄糖对细胞起抑制作用,可显著抑制VEC-304的生长;高浓度黄芪及高浓度黄芪（≥300mg/L）联合24hIC50葡萄糖对细胞有增殖作用。（2）葡萄糖组VEGF mRNA和蛋白表达下调,高浓度黄芪联合24hIC50葡萄糖组VEGF mRNA和蛋白表达正常。结论高浓度葡萄糖抑制VEC-304增值,高浓度黄芪促进VEC-304增值,黄芪可保护高浓度葡萄糖所致的血管损伤。     

尿酸盐致血管内皮细胞损伤的机制

目的观察不同浓度尿酸盐对人血管内皮细胞损伤相关因子表达的影响,明确高尿酸血症对人血管内皮细胞的损伤的机制。方法体外单独培养人血管内皮细胞或与单核细胞共培养,尿酸盐分别用6．6mg／dl（约为人体男、女高尿酸血症最低值平均值）及该值2、3、4、5倍值刺激血管内皮细胞48小时,用酶联免疫吸附双抗体夹心法（ELISA）测定上清液白细胞介素1（IL-1）、肿瘤坏死因子α（TNF-d）、细胞间粘附分子-1（ICAM-1）、血浆纤溶酶原激活抑制剂-1（PAI-1）等因子表达水平,用逆转录-聚合酶链式反应（RT-PcR）测定血管内皮细胞人尿酸盐转运子（hUAT）mRNA的表达。结果①不同浓度尿酸盐与血管内皮细胞单独培养：结果显示高浓度尿酸盐使血管内皮细胞IL-l、TNF-Ⅸ、ICAM-1、PAI-1的表达上调,明显高于对照组（P均〈0．05）;②不同浓度尿酸盐与血管内皮细胞及单核细胞共培养：结果显示高浓度尿酸盐使血管内皮细胞IL-1、TNF-α、ICAM-1、PAI-1的表达进一步增高,明显高于对照组（P均〈0．05）;③hUATmRNA表达：高浓度尿酸盐使血管内皮细胞hUATmRNA表达明显低于对照组（P〈0．05）;与单核细胞共培养高浓度尿酸盐使血管内皮细胞hUATmRNA表达明显进一步下调（P〈0．05）。结论尿酸盐可以作为独立的危险因素引起内皮细胞的直接损伤,单核细胞在内皮细胞损伤过程中亦起到了重要作用,血管内皮细胞和单核细胞共培养使血管内皮细胞损伤进一步加重。     

抵抗素、脂联素对原代培养的脐静脉内皮细胞分泌NO、ET-1、TGF-β1的影响

目的观察抵抗素、脂联素对原代培养的脐静脉内皮细胞（HUVECs）分泌一氧化氮（NO）、内皮素1（ET-1）和转化生长因子艮（TGF—β1）的影响。方法用含不同浓度抵抗素（10、50、100ng／ml）、抗抵抗素抗体加高浓度抵抗素（100ng／ml）、脂联素（10μg／ml）加高浓度抵抗素的无血清RPMI 1640液培养HUVECs24、48h，取上清液测定NO、ET-1和TGF-β1水平。结果抵抗素呈剂量依赖性促进HUVECs分泌ET-1和TGF-β1（P〈0．01，〈0．05），对NO无明显影响（P〉0．05）。生理剂量的脂联素能增加NO释放（P〈0．05），对高浓度抵抗素引起的ET-1分泌无明显抑制作用，对高浓度抵抗素引起的TGF-β1分泌有部分抑制作用（P〈0．05）。结论抵抗素能刺激血管内皮细胞过度分泌ET-1和TGF-β1导致血管内皮细胞功能紊乱，加速糖尿病（DM）血管病变的发生发展。脂联素在DM血管病变的发生发展中起保护作用。     

不同浓度葡萄糖对人血管内皮细胞的影响

目的研究高浓度葡萄糖对人血管内皮细胞的影响。方法在人脐静脉内皮细胞株ECV304培养基中分别加入5.5、20、40 mmol/L葡萄糖,作用24~72 h。采用四甲基偶氮唑盐微量酶反应比色（MTT）法观察细胞增殖情况,倒置相差显微镜观察细胞形态,透射电镜观察内皮细胞V304凋亡情况;流式细胞术检测细胞凋亡率。结果高浓度葡萄糖能明显抑制血管内皮细胞的增殖,诱导培养的内皮细胞发生凋亡,细胞凋亡率增加,并随浓度的增高、时间的延长作用明显。结论高浓度葡萄糖能抑制培养的人血管内皮细胞增殖,促进细胞凋亡。     

ACE2基因表达增加对人脐静脉内皮细胞增殖、凋亡的影响

目的探索在AngII干预下ACE2基因表达增加对人血管内皮细胞增殖、凋亡的影响。方法原代培养人脐静脉血管内皮细胞。用构建、包装好的慢病毒重组ACE2基因表达载体（Lentiviral—ACE2）以感染复数为10（MOI=10）感染人脐静脉内皮细胞（HUVEC）。感染72h后,以AnglI（终浓度为10。mol／L）干预细胞,倒置相差显微镜观察各组HUVEC的形态学变化,AlamarBlue试剂检测各组HUVEC增殖功能,TUNEL细胞凋亡检测试剂盒检测各组HUVEC的凋亡。结果AngⅡ组与AngII＋Lentiviral—GFP组细胞生长状态差,生长缓慢,形态不规则并且有不同程度脱壁悬浮的细胞;而正常细胞对照组与AngII＋Lentiviral—ACE2组细胞生长状态良好,圆形、卵圆形,饱满,形态正常呈“铺路石”样生长,紧密贴壁,悬浮细胞少。AngII组较正常细胞对照组、Ang1I＋Lentiviral—ACE2组AlamarBlue被还原率明显降低（P〈O．05）。Ang11组的凋亡指数为（0．1165±0．0181）,与正常细胞对照组凋亡指数（0．0373±0．0113）和AngⅡ＋Lentiviral—ACE2组凋亡指数（0．0540±0．0061）相比差异有统计学意义（P〈0．05）。AngII组与AngⅡ＋Lentiviral—GFP相比、正常细胞对照组与AngII＋Lentiviral—ACE2组相比,AlamarBlue被还原率和凋亡指数差异无统计学意义。结论AngⅡ具有促进人脐静脉内皮细胞增殖能力下降和凋亡增加的作用。ACE2表达增~IIII抑制AngⅡ诱导的人脐静脉内皮细朐增殖活件降低和凋亡增加．对人脐静脉内皮细胞具有保护作用。     

抵抗素对原代培养的脐静脉内皮细胞分泌ET-1、TGF-β1的影响

目的观察抵抗素对原代培养的脐静脉内皮细胞（HUVECs）产生内皮素-1（ET-1）和转化生长后子-β1（TGF-β1）的影响。方法分别用含不同浓度抵抗素、抗抵抗素IgG加高浓度抵抗素、脂联素加高浓度抵抗番的无血清RPMI 1640液培养HUVECs 48h，用放射免疫法测定其上清液中的ET-1水平，用ELISA法测定爿TGF-β1水平。结果抵抗素呈剂量依赖性促进HUVECs分泌ET-1（P〈0.01）和TGF-β1（P〈0．05）。抗抵抗京IgG能够完全抑制高浓度抵抗索引起的ET-1和TGF-β1分泌（P〉0．05）。生理剂量的脂联素对高浓度抵抗素引起的ET-1的分泌无明显抑制作用（P〉0．05），对高浓度抵抗素引起的TGF-β1：分泌有部分抑制作用（P〈0．05）。结论抵抗素导致血管内皮细胞功能紊乱。促发糖尿病血管病变。而脂联素在糖尿病血管病变中起保护作用。     

新VEGFR2靶向抑制剂筛选及其抗肿瘤生物学活性检测

目的从8种新合成血管内皮细胞生长因子受体2（vascularendothelialgrowthfactorreceptor2,VEGFR2）靶向抑制剂中筛选有效抑制VEGFR2的药物,并检测其抗肿瘤效果。方法8种VEGFR2靶向抑制剂（标记为1—8号）各配成6种浓度分别作用于人脐静脉血管内皮细胞（humanumbilicalveinendothelialcells,HUVEC）和舌癌细胞株（Tea8113）细胞,同时设置5-氟尿嘧啶（5-FU）为阳性对照组,无药物组为空白对照组。用噻唑蓝（MTT）法检测细胞生长情况,免疫细胞化学法检测饱和浓度VEGFR2抑制剂组和空白对照组细胞VEGFR2表达,以验证抑制剂对VEGFR2的作用效应。结果与空白对照组相比,阳性对照组能显著抑制这两种细胞的生长增殖（P〈0．05）,不同浓度各VEGFR2靶向抑制剂组对这两种细胞生长增殖的差异均无统计学意义（P〉0．05）。免疫细胞化学结果显示,空白对照组Tca8113细胞和HUVEC细胞膜上VEGFR2高表达;与空白对照组相比,饱和浓度不同抑制剂组的Tca8113细胞中只有6号试剂组可以显著下调细胞膜上VEGFR2表达（P=0．000）,而HUVEC各组VEGFR2表达差异均无统计学意义（P〉0．05）。结论这些VEGFR2靶向抑制剂对人脐静脉血管内皮细胞和舌癌细胞生长增殖无抑制作用,其中只有6号抑制剂能显著下调舌癌细胞VEGFR2表达,可以作为进一步研究的候选药物。     

环孢素A对人脐静脉内皮细胞的损伤作用

本实验取人脐静脉内皮细胞进行培养，加不同浓度的环孢是A孵育后，在光镜和透射电镜下观察到CSA对培养的血管内皮细胞具有损伤作用，有明显的形态学变化．监测细胞培养上清液获中乳酶脱氢酶（LDH）、血栓调节蛋白（TM）的变化．TM浓度随CsA浓度和作用时间呈依赖性的变化，TM作为血管内皮细胞损伤的指标比LDH敏感．在高浓度组中（CsA：1600μg／L、3200μg／L）TM值与对照组间差异显著（P＜0．05）．     

氟对骨髓基质细胞增殖和成骨能力的影响

目的探讨氟对体外培养的大鼠骨髓基质细胞（MSCs）增殖能力与成骨能力的影响。方法体外培养大鼠MSCs。噻唑蓝（MTT）比色法分析不同染氟水平下MSCs的增殖能力；光、电镜下观察不同染氟水平下MSCs成骨转化能力和相应超微结构变化。结果与对照组比较，低水平染氟（0．02mg／L）96h后促进MSCs增殖（P〈0．05）；较高水平染氟（0．05～1．00mg／L）72h即可促进MSCs增殖（P〈0．05或〈0．01）；高水平染氟（10．00、20．00mg／L）对MSCs具有抑制增殖和促细胞凋亡作用（P〈0．01）。较高水平染氟（2．00～20．00mg／L）时MSCs成骨转化受抑（P〈0．01），较低水平染氟（0．01～1．00mg／L）时MSCs成骨转化增强（P〈0．01）。结论低水平染氟促进MSCs增殖。成骨转化能力增强；高水平染氟抑制MSCs增殖，促进细胞凋亡，抑制MSCs成骨转化能力。     

不同的脂肪酸对人血管内皮细胞增殖和凋亡的影响

目的 了解游离脂肪酸（FFAs）对体外培养的人脐静脉内皮细胞（human umbilical veinen dothelialcells，HUVEC）凋亡及生长周期的影响。方法 用不同种类，不同浓度的FFAs培养人血管内皮细胞（VEC），然后应用流式细胞术（FCM）对培养的人VEC生长周期及细胞凋亡进行分析。结果 饱和脂肪酸（SFA）（C16：0，C18：0，C24：0），使培养的人VEC生长受到抑制，随浓度升高细胞凋亡率升高；不饱和脂肪酸（USFA）（C18：1，C18：2），当低浓度时，VEC凋亡率较低（P〉0．05，P〉0．01），而当达400或600μmol／L时凋亡率升高（P〈0．05，P〈0．01）。结论 SFA对培养的人VEC具有抑制增殖及诱导凋亡的作用。低浓度USFA对VEC凋亡及生长周期的影响不大，但高浓度时，其诱导凋亡的作用增强。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El^® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.