Sunitinib对支气管哮喘气道重塑小鼠模型Erk通路和cyclin D1表达的影响

目的 探讨sunitinib对支气管哮喘(简称哮喘)气道重塑的干预作用及可能的作用机制.方法 18只BALB/c小鼠随机分为对照组、哮喘组以及sunitinib组,每组6只;以卵清蛋白(OVA)致敏、激发,建立慢性哮喘气道重塑模型.Sunitinib组每次雾化吸人前半小时给予sunitinib(40 mg/kg)灌胃给药.OVA末次激发结束后24 h处死小鼠,HE染色观察气道炎症及形态学改变,采用ELISA法检测支气管肺泡灌洗液(BALF)中IL-4、IL-13和血清总IgE的表达,免疫组织化学法观察肺组织增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)、α平滑肌肌动蛋白(a smooth muscle actin,α SMA)表达水平.蛋白印记法(Western blot)测定细胞外信号调节蛋白激酶(extraeellular signal-regulated kinase,Erk)蛋白磷酸化水平及细胞周期蛋白D1(cyclin D1)的表达.结果 HE染色示哮喘组小鼠黏膜下层和平滑肌层增厚,管腔狭窄,大量炎性细胞浸润,sunitinib组上述改变较哮喘组为轻;sunitinib干预后哮喘小鼠BALF中Th2细胞因子IL4、IL-13和血清总IgE以及肺组织羟脯氨酸含量显著降低(P＜0.01).哮喘组小鼠气道PCNA阳性细胞百分比、α-SMA表达及肺组织Erk磷酸化水平、cyclin D1蛋白表达较对照组明显升高(P＜0.01),sunitinib干预后其表达均降低(P＜0.01).结论 Sunitinib可能通过抑制Erk途径影响cyclin D1的表达,抑制了慢性哮喘模型中气道平滑肌的增殖,发挥抗气道重塑作用.     

Sunitinib对支气管哮喘气道重塑小鼠模型Erk通路和cyclin D1表达的影响

目的探讨sunitinib对支气管哮喘(简称哮喘)气道重塑的干预作用及可能的作用机制。方法 18只BALB/c小鼠随机分为对照组、哮喘组以及sunitinib组,每组6只;以卵清蛋白(OVA)致敏、激发,建立慢性哮喘气道重塑模型。Sunitinib组每次雾化吸入前半小时给予sunitinib(40mg/kg)灌胃给药。OVA末次激发结束后24h处死小鼠,HE染色观察气道炎症及形态学改变,采用ELISA法检测支气管肺泡灌洗液(BALF)中IL-4、IL-13和血清总IgE的表达,免疫组织化学法观察肺组织增殖细胞核抗原(proliferatingcell nuclear antigen,PCNA)、α平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)表达水平。蛋白印记法(Westernblot)测定细胞外信号调节蛋白激酶(extracellular signal-regulated kinase,Erk)蛋白磷酸化水平及细胞周期蛋白D1(cyclin D1)的表达。结果 HE染色示哮喘组小鼠黏膜下层和平滑肌层增厚,管腔狭窄,大量炎性细胞浸润,sunitinib组上述改变较哮喘组为轻;sunitinib干预后哮喘小鼠BALF中Th2细胞因子IL-4、IL-13和血清总IgE以及肺组织羟脯氨酸含量显著降低(P0.01)。哮喘组小鼠气道PCNA阳性细胞百分比、α-SMA表达及肺组织Erk磷酸化水平、cyclin D1蛋白表达较对照组明显升高(P0.01),sunitinib干预后其表达均降低(P0.01)。结论 Sunitinib可能通过抑制Erk途径影响cyclin D1的表达,抑制了慢性哮喘模型中气道平滑肌的增殖,发挥抗气道重塑作用。     

法舒地尔对支气管哮喘小鼠肺组织Rho激酶-1表达及气道炎症的影响

目的 观察Rho激酶-1抑制剂法舒地尔对支气管哮喘(简称哮喘)小鼠肺组织Rho激酶-1表达及气道炎症的影响,探讨Rho激酶-1在哮喘气道炎症中的作用机制.方法 将24只BalB/c小鼠采用随机数字表法分为对照组、哮喘组和干预组,每组8只.哮喘组、干预组小鼠分别给予卵清白蛋白(OVA)致敏和激发.每次雾化前1 h,干预组给予法舒地尔(10 mg/kg)腹腔注射.末次激发后收集BalF,离心后计数细胞总数及嗜酸粒细胞(EOS)数量.ELISA法测定BalF上清液中嗜酸粒细胞趋化因子(Eotaxin)、白细胞介素(IL)-5和IL-13水平.肺组织HE染色.采用逆转录PCR和免疫组织化学测定各组小鼠肺组织中Rho激酶-1 mRNA和蛋白的表达水平.结果 (1)哮喘组BalF中细胞总数及EOS数量分别为(1.45±0.12)× 10~9/L和(0.52 ±0.06)× 10~9/L,明显高于对照组[分别为(0.58±0.06)×10~9/L和(0.01±0.01)×10~9/L](q值分别为25.909和35.002,均P＜0.01)和干预组[分别为(0.89 ±0.09)×10~9/L和(0.20±0.04)×10~9/L](q值分别为16.676和21.537,均P＜0.01).(2)哮喘组Eotaxin、IL-5及IL-13水平分别为(45±8)ng/L、(157 ±23)ng/L和(429±46)ng/L,明显高于对照组[分别为(10 ±3)ng/L、(26±6)ng/L和(126 ±20)ng/L](q值分别为18.246、23.009、25.826,均P＜0.01);干预组分别为(20±5)ng/L、(57 ±14)ng/L和(254±28)ng/L,明显低于哮喘组(q值分别为13.119、17.503、8.449,均P＜0.01).(3)对照组小鼠气道周围无炎症细胞浸润,哮喘组小鼠气道黏膜水肿,气道壁及管周有大量以EOS为主的炎症细胞浸润,干预组气道炎症反应较哮喘组减轻.(4)哮喘组肺组织Rho激酶-1 mRNA和蛋白的表达水平明显高于对照组(q值分别为25.614和8.156,均P＜0.01),干预组Rho激酶-1 mRNA和蛋白表达水平低于哮喘组(q值分别为20.379和4.135,均P＜0.01).(5)Rho激酶-1 mRNA表达量与BalF中EOS数量、Eotaxin、IL-5和IL-13水平呈正相关(r值分别为0.709、0.600、0.613、0.650,均P＜0.01).结论 Rho激酶-1参与过敏原诱导的哮喘小鼠气道炎症的发生,应用法舒地尔抑制其表达和活性可能改善哮喘气道炎症.     

支气管哮喘小鼠模型中维生素D相关分子的表达

目的 探讨维生素D相关分子在支气管哮喘(简称哮喘)小鼠模型中的表达及地塞米松的干预效果.方法 用卵白蛋白作为致敏原制备小鼠哮喘模型,随机分为两组(n=6),分别为地塞米松处理组和生理盐水处理组(对照组),收集各组小鼠的支气管肺泡灌洗液和支气管组织,计数总细胞数和白细胞分类数,采用real-time RT-PCR技术检测支气管组织中维生素D3上调蛋白1(VDUP1)、维生素D受体(VDR)和1α羟化酶CYP27B1的mRNA表达水平.结果 哮喘组支气管组织中VDUP1mRNA、VDRmRNA和CYP27 B1mRNA水平分别为(2.74±0.99)、(7.06±4.05)和(3.40±2.16),明显高于对照组(分别为1.01±0.18、1.28±0.76、1.45±1.39,P＜0.05)和地塞米松治疗组(分别为0.94±0.34、0.76±0.18、0.27±0.17,P＜0.01).结论 维生素D相关分子可能参与了哮喘的发病过程.     

转化生长因子β1Ⅰ型受体拮抗剂对支气管哮喘小鼠气道炎症及气道重塑的影响

目的 研究转化生长因子β1(TGF-β1)Ⅰ型受体拮抗剂SB 431542对慢性支气管哮喘(简称哮喘)小鼠模型气道炎症及气道重塑的影响,为哮喘的治疗提供新思路.方法 将40只BALB/c小鼠随机分为正常组、哮喘组、布地奈德组及SB 431542组,每组10只;卵清蛋白(OVA)致敏、激发建立慢性哮喘小鼠模型;布地奈德组和SB 431542组分别给予布地奈德雾化吸入和SB 431542滴鼻,每周3次.HE和Masson染色观察各组小鼠气道炎症及胶原沉积情况;AB-PAS染色观察杯状细胞增生情况;免疫组织化学半定量法测定气道壁α-平滑肌肌动蛋白(α-SMA)的表达;酶联免疫吸附试验(ELISA)法检测BALF中IL-4、IL-5、TGF-β1、MMP-9、TIMP-1水平及血清总IgE水平;免疫印迹法(Western blot)测定各组小鼠肺组织中Smad3、p-Smad3及Smad7蛋白表达.结果 哮喘组与正常组相比,嗜酸粒细胞浸润增多,气道管腔狭窄,平滑肌层增厚,胶原纤维增生;布地奈德组上述改变均较哮喘组轻;SB 431542组嗜酸粒细胞浸润较哮喘组减轻,但仍高于正常组及布地奈德组,平滑肌层增厚、胶原纤维增生较哮喘组明显减轻(P＜0.05),与布地奈德组比较差异无统计学意义(P＞0.05).与正常组比较,哮喘组小鼠支气管AB-PAS及α-SMA 阳性染色面积/支气管基底膜周径显著增加(P＜0.05),布地奈德组及SB 431542组小鼠支气管AB-PAS及α-SMA 阳性染色面积/支气管基底膜周径低于哮喘组(P＜0.05).哮喘组气道炎症指标(血清总IgE、IL-4、IL-5及TGF-β1)显著高于正常组(P＜0.05),布地奈德组上述指标低于哮喘组(P＜0.05),SB 431542组与哮喘组比较差异无统计学意义(P＞0.05).MMP-9、TIMP-1在哮喘组的表达明显高于正常组(P＜0.05),在布地奈德组及SB 43542组的表达低于哮喘组(P＜0.05),两治疗组之间差异无统计学意义(P＞0.05).Western blot检测显示,各组小鼠肺组织Smad3的表达差异无统计学意义(P＞0.05);哮喘组p-Smad3表达明显高于正常组(P＜0.05),布地奈德组及SB 431542组p-Smad3表达低于哮喘组(P＜0.05);与正常组比较,哮喘组Smad7表达降低(P＜0.05),布地奈德组及SB 431542组Smad7表达高于哮喘组(P＜0.05),且这两组间差异无统计学意义(P＞0.05).结论 SB 431542能显著减轻哮喘小鼠细胞外基质沉积及平滑肌增厚,延缓哮喘小鼠气道重塑进程,该作用可能部分与其调节MMP-9、TIMP-1的表达有关.SB 431542对哮喘小鼠气道炎症浸润无明显改善,说明哮喘气道炎症可能不依赖于TGF-β1/Smads通路.     

钙池操纵性钙通道抑制剂SKF96365对慢性哮喘小鼠气道重塑和气道高反应性的作用

目的:观察钙池操纵性钙通道抑制剂SKF96365对小鼠慢性哮喘模型气道重塑和气道高反应性的影响。方法:用鸡卵清白蛋白(OVA)致敏和激发小鼠,建立慢性哮喘模型,33只雌性BALB/c小鼠随机分为3组:对照组、哮喘组、SKF96365组,每组11只,其中SKF96365组于每次激发前30 min给予SKF96365(10mg/kg)干预。哮喘组和SKF96365组于第0、7、14 d腹腔注射(i.p)200μL致敏液(含OVA粉剂20μg、氢氧化铝凝胶2 mg);自第21天起,腹腔注射1%戊巴比妥钠(70mg戊巴比妥钠/kg小鼠体重)麻醉小鼠后,OVA(40μg)滴鼻(i.n),连续6周,每周3次,共18次。对照组则在相同时间给予相应剂量的生理盐水腹腔注射和滴鼻。最后一次激发后24 h,各组分别随机取5只小鼠用于检测组织病理学变化,另6只小鼠采用Buxco小动物肺功能仪检测气道高反应性。其中组织病理学检测计算杯状细胞(过碘酸希夫染色阳性,PAS+)、胶原细胞(Masson阳性)和平滑肌细胞(α-SMA阳性)阳染面积/支气管基底膜周长值来评估小鼠气道重塑;观察给予不同浓度乙酰甲胆碱雾化时的气道阻力(resistance index,RI)最大值,评估小鼠气道高反应性。结果:对照组未见PAS阳性染色区域,哮喘组和SKF96365组杯状细胞增生高于对照组(7.29±2.04,4.49±1.70 vs 0.00±0.00,均P0.01),且SKF96365组低于哮喘组(P0.05)。Masson染色显示哮喘组和SKF96365组上皮下胶原沉积高于对照组(9.23±1.41,7.30±1.33 vs 1.60±0.77,均P0.01),且SKF96365组低于哮喘组(P0.05)。α-SMA免疫组化显示哮喘组和SKF96365组平滑肌增生肥大高于对照组(4.54±1.05,3.15±0.57 vs 1.97±0.69,均P0.05),且SKF96365组低于哮喘组(P0.05)。当乙酰甲胆碱(Mch)≤6.25 mg/m L时,3组小鼠气道阻力无显著差异(P0.05),当25 mg/m LMch≥12.25 mg/m L时,哮喘组小鼠气道阻力明显大于对照组小鼠(P0.001),当Mch≥25 mg/m L时,哮喘组小鼠气道阻力大于SKF96365组(P0.05)。结论:采用SKF96365干预后,慢性哮喘小鼠气道重塑和气道高反应性指标均有改善,提示SKF96365可能对哮喘气道重塑和气道高反应性具有抑制作用。     

转化生长因子β1Ⅰ型受体拮抗剂对支气管哮喘小鼠气道炎症及气道重塑的影响

目的 研究转化生长因子β1(TGF-β1)Ⅰ型受体拮抗剂SB 431542对慢性支气管哮喘(简称哮喘)小鼠模型气道炎症及气道重塑的影响,为哮喘的治疗提供新思路.方法 将40只BALB/c小鼠随机分为正常组、哮喘组、布地奈德组及SB 431542组,每组10只;卵清蛋白(OVA)致敏、激发建立慢性哮喘小鼠模型;布地奈德组和SB 431542组分别给予布地奈德雾化吸入和SB 431542滴鼻,每周3次.HE和Masson染色观察各组小鼠气道炎症及胶原沉积情况;AB-PAS染色观察杯状细胞增生情况;免疫组织化学半定量法测定气道壁α-平滑肌肌动蛋白(α-SMA)的表达;酶联免疫吸附试验(ELISA)法检测BALF中IL-4、IL-5、TGF-β1、MMP-9、TIMP-1水平及血清总IgE水平;免疫印迹法(Western blot)测定各组小鼠肺组织中Smad3、p-Smad3及Smad7蛋白表达.结果 哮喘组与正常组相比,嗜酸粒细胞浸润增多,气道管腔狭窄,平滑肌层增厚,胶原纤维增生;布地奈德组上述改变均较哮喘组轻;SB 431542组嗜酸粒细胞浸润较哮喘组减轻,但仍高于正常组及布地奈德组,平滑肌层增厚、胶原纤维增生较哮喘组明显减轻(P ＜0.05),与布地奈德组比较差异无统计学意义(P＞0.05).与正常组比较,哮喘组小鼠支气管AB-PAS及a-SMA阳性染色面积/支气管基底膜周径显著增加(P＜0.05),布地奈德组及SB 431542组小鼠支气管AB-PAS及α-SMA阳性染色面积/支气管基底膜周径低于哮喘组(P＜0.05).哮喘组气道炎症指标(血清总IgE、IL-4、IL-5及TGF-β1)显著高于正常组(P＜0.05),布地奈德组上述指标低于哮喘组(P ＜0.05),SB 431542组与哮喘组比较差异无统计学意义(P＞0.05).MMP-9、TIMP-1在哮喘组的表达明显高于正常组(P＜0.05),在布地奈德组及SB 43542组的表达低于哮喘组(P＜0.05),两治疗组之间差异无统计学意义(P＞0.05).Western blot检测显示,各组小鼠肺组织Smad3的表达差异无统计学意义(P＞0.05);哮喘组p-Smad3表达明显高于正常组(P＜0.05),布地奈德组及SB431542组p-Smad3表达低于哮喘组(P＜0.05);与正常组比较,哮喘组Smad7表达降低(P＜0.05),布地奈德组及SB 431542组Smad7表达高于哮喘组(P＜0.05),且这两组间差异无统计学意义(P＞0.05).结论 SB 431542能显著减轻哮喘小鼠细胞外基质沉积及平滑肌增厚,延缓哮喘小鼠气道重塑进程,该作用可能部分与其调节MMP-9、TIMP-1的表达有关.SB 431542对哮喘小鼠气道炎症浸润无明显改善,说明哮喘气道炎症可能不依赖于TGF-β1/Smads通路.     

L-精氨酸对哮喘大鼠气道平滑肌细胞增殖的影响

目的 观察L-精氨酸(L-Arg)对哮喘气道重构大鼠气道平滑肌细胞(ASMC)的细胞周期分布及细胞周期调节蛋白(CCRP)表达水平的影响,探讨L-Arg体内干预哮喘大鼠ASMC增殖的可能作用机制.方法 实验分成对照组、哮喘组、L-Arg组,建立大鼠哮喘气道重构模型,检测血清NO-2/NO-3含量、肺内支气管内管壁和平滑肌层厚度及ASMC核数、ASMC的细胞周期分布以及ASMC内细胞周期素E(cyclin E)、cyclin A、cyclin B、蛋白27kip1(P27kip1)的表达.结果 哮喘组大鼠支气管内管壁、平滑肌层的厚度和ASMC数目显著大于对照组(P<0.05);L-Arg组大鼠支气管内管壁的厚度、平滑肌层的厚度和ASMC数目显著小于哮喘组(P<0.05).哮喘组血清一氧化氮(nitricoxide,NO)水平显著低于对照组(P<0.05);L-Arg组血清NO水平显著高于哮喘组(P<0.01).哮喘组G0/G1期ASMC比例及P27kip1表达水平显著低于对照组(P<0.01),G2/M+S期ASMC比例及cyclin E、cyclin A和cyclin B表达水平显著高于对照组(P<0.01);L-Arg组G0/G1期ASMC比例及P27kip1表达水平显著高于哮喘组(P<0.05),G2/M+S期ASMC比例及cyclin E和cyclin A表达水平显著低于哮喘组(P<0.05).结论 L-Arg通过调控CCRP的表达水平阻滞细胞从G1期进入S期而抑制哮喘ASMC的增殖.     

咪喹莫特治疗支气管哮喘作用机制的实验研究

目的 研究新型免疫调节剂咪喹莫特对支气管哮喘(简称哮喘)的治疗作用,探讨其可能的作用机制.方法 (1)40只BALB/c小鼠(每组10只)和48只SD大鼠(每组12只)分为对照组、哮喘组、咪喹莫特组和地塞米松组,建立大鼠和小鼠哮喘模型.用卵清白蛋白激发前吸入0.15%咪喹莫特混悬液5 ml.末次激发后24 h观察肺组织炎症及测定气道反应性;用逆转录-聚合酶链反应(RT-PCR)法测定肺组织中白细胞介素4(IL-4)、γ干扰素(IFN-γ)、嗜酸粒细胞活化趋化因子(eotaxin)、巨噬细胞衍生趋化因子(MDC)、胸腺和活化调节趋化因子(TARC)、T-bet、GATA-3、信息转导转录激活子6(STAT6)mRNA的表达;用酶联免疫吸附试验(ELISA)法测定血清中eotaxin、MDC、TARC及支气管肺泡灌洗液中IL-4和IFN-γ浓度;用Western blot法测定肺组织中T-bet、GATA-3、STAT6蛋白水平;(2)分离和培养致敏大鼠气管旁淋巴结细胞(PBLN),分为空白对照组、阳性对照组、地塞米松组和药物1～3组,测定不同时间点各组细胞上清液中IL-4、IFN-γ蛋白和细胞的mRNA表达;(3)分离和培养致敏小鼠的脾脏T淋巴细胞,用流式细胞仪测定经咪喹莫特刺激后不同时间点细胞内IL-4、IFN-γ水平;(4)培养致敏大鼠CD+4T淋巴细胞,测定经咪喹莫特干预后T-bet、GATA-3 mRNA和蛋白的表达水平.结果 用同等剂量氯化乙酰胆碱(20、40、80、160μg/ml)激发时平均呼气阻力哮喘组分别为(6.26±0.85)、(11.55±3.09)、(28.74±5.94)、(3710.83±197.49)cm H20·ml-1·s-1(1 cm H20=0.098 kPa),咪喹莫特组分别为(1.34±0.16)、(3.47±0.49)、(9.29±1.27)、(25.22±5.44)cm H2O·ml-1·s-1,两组相同剂量比较差异有统计学意义(D值分别为88.98、56.00、45.00、108.00,P均＜0.01);哮喘组大鼠气道壁和肺组织中嗜酸粒细胞(EOS)、淋巴细胞、管壁面积/支气管管腔内周长(WA/Pi)、支气管平滑肌面积/支气管管腔内周长(ASM/Pi)分别为(26.0±1.6)、(45.2±3.2)个/mm2、12.0±1.4、6.7±0.6,咪喹莫特组分别为(12.4±2.9)、(24.2±3.7)个/mm2、9.2±0.6、4.0±0.5,两组比较差异有统计学意义(D和q值分别为193.00、16.92、185.50、7.66,P均＜0.01);哮喘组肺组织中T-bet mRNA和蛋白表达量分别为0.08±0.12、0.18±0.06,咪喹莫特组分别为0.48±0.08、0.48±0.17,两组比较差异有统计学意义(D值分别为120.96、177.98,P均＜0.01);哮喘组肺组织中GATA-3 mRNA和蛋白表达量分别为1.56±0.28、2.25±0.74,咪喹莫特组分别为0.54±0.14、0.50±0.14,两组比较差异有统计学意义(D值分别为166.96、310.97,P均＜0.01);空白对照组24、48 h时PBLN细胞培养液中IL-4、IFN-γ分别为(0±0、0±0、22±5、31±5) pg/ml.随着培养时间的延长,药物2组24、48 h时IL-4、IFN-γ水平分别为(23±5)、(39±11)、(149±31)、(154±28) pg/ml,药物3组24、48 h时IL-4、IFN-γ水平分别为(25±6)、(40±12)、(166±30)、(158±31) pg/ml,与阳性对照组[(43±13)、(56±12)、(100±22)、(112±33) pg/ml)]比较差异有统计学意义(药物2、3组24、48 h时IL-4的D值分别为9.90、8.79、8.80、8.10;药物2、3组24、48 h时IFN-γ的q值分别为4.80、6.40、3.95、4.31,P均＜0.05);哮喘组小鼠BALF中细胞总数及EOS分别为(8.7±1.4)×106 /L、(29.80±7.00)%,咪喹莫特组为(4.1±1.3)×106 /L、(8.90±2.40)%,两组比较差异有统计学意义(q值分别为16.40、7.40,P均＜0.05);哮喘组小鼠血清eotaxin、MDC和TARC水平分别为(593±41)、(170±20)、(221±25) pg/ml,咪喹莫特组分别为(501±76)、(84±13)、(163±35) pg/ml,两组比较差异有统计学意义(q值分别为3.70、9.80、4.50,P均＜0.05);(4)咪喹莫特组小鼠肺组织eotaxin、MDC、TARC mRNA表达分别为0.65±0.17、0.66±0.12、0.66±0.34,哮喘组分别为0.85±0.11、0.96±0.10、0.94±0.28,对照组分别为0.45±0.08、0.39±0.09、0.24±0.08,哮喘组与咪喹莫特组比较差异有统计学意义(q值分别为1.50、8.10、2.40,P均＜0.05);哮喘组与对照组比较差异有统计学意义(q值分别为3.00、15.40、5.90,P均＜0.05).结论 咪喹莫特可能通过提高转录因子T-bet mRNA\蛋白的表达和抑制转录因子GATA-3和STAT6 mRNA和蛋白表达,使失衡的Th1/Th2细胞得以纠正,从而抑制哮喘气道炎症.     

细胞周期蛋白D1在支气管哮喘小鼠肺组织中的表达及其与气道重塑的关系

目的 研究细胞周期蛋白D1(Cyclin D1)在支气管哮喘(简称哮喘)小鼠肺组织中的表达,探讨Cyclin D1在哮喘及气道重塑中的作用.方法 将40只SPF级BALB/c小鼠按随机数字表法分为正常对照组(A组)、哮喘雾化2周组(B组)、哮喘雾化4周组(C组)、哮喘雾化8周组(D组)4组,每组10只.用10%鸡卵白蛋白(OVA)致敏和1%OVA激发小鼠建立哮喘模型.分析支气管肺泡灌洗液(BALF)中嗜酸粒细胞(EOS)计数及分类;用动物肺功能仪检测各组小鼠肺功能状况;用苏木精-伊红(HE)染色观察气道炎症及细胞浸润情况;用图像分析软件观察气道壁及平滑肌层变化情况;用逆转录-聚合酶链反应(RT-PCR)及实时定量(Real-time)PCR测定肺组织中Cyclin D1 mRNA水平表达变化;用Western blot法观察肺组织中Cyclin D1的蛋白表达变化.结果 BALF分析结果提示,B、C、D组EOS计数分别为(42.6±0.9)×104/L、(54.7±1.4)×104/L、(44.8±2.4)×104/L,与A组[(3.4±0.5)×104/L]比较差异有统计学意义(q值分别为79.75、91.42、84.82,P均＜0.01);对小鼠呼气阻力检测发现,乙酰胆碱浓度为45 μg/kg时B、C、D组分别为(5.27±0.16)cm·L-1·min-1、(6.68士0.20)cm·L-1·min-1、(7.14±0.41)cm·L-1·min-1,与A组[(4.11±0.15)cm·L-1·min-1]比较差异有统计学意义(q值分别为5.58、6.39、7.11,P均＜0.05);支气管平滑肌面积/管腔内周长(Wam/Pi)B组为2.8±0.6,C组为4.8±0.6,D组为6.4±0.7,与A组(2.4±0.4)比较差异有统计学意义(q值分别为6.40、8.28、9.27,P＜0.05);管壁面积/管腔内周长(Wat/Pi)B组为6.4±0.8,C组为8.3±1.2,D组为9.3±1.0,与A组(5.6±1.0)比较差异有统计学意义(q值分别为2.80、4.83、6.37,P均＜0.05);Western blot检测发现Cyclin D1在B、C、D组表达量分别为0.587±0.015、0.808±0.029、0.826±0.022,与A组(0.404±0.016)比较差异有统计学意义(q值分别为5.87、8.08、8.26,P均＜0.01);相关性分析结果提示呼气阻力和Cyclin D1水平表达呈正相关(r=0.83,P＜0.05).结论 Cyclin D1在哮喘小鼠肺组织中表达增加,其表达与气道反应性呈正相关,Cyclin D1可能通过细胞外信号调节激酶(ERK)信号通路参与气道重塑过程.     

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。     

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。     

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。     

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.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.