抑制核因子-κB对糖尿病肾病的作用

目的　研究抑制核因子 κB(NF κB)活性对糖尿病肾病 (DN)及糖尿病大鼠肾组织纤维连接蛋白 (FN)mRNA表达的作用。方法　将纯种雄性Wistar大鼠分为 :A组为正常对照组 (1 1只 ) ,B组为糖尿病无干预组 (1 1只 ) ,C组为吡咯烷二硫基甲酸酯 (PDTC ,NF κB抑制剂 )干预组 (9只 )。饲养 1 8周后 ,以电泳迁移率变动分析技术检测肾组织NF κB活性 ,透射电镜检测肾小球基底膜厚度及系膜基质密度 (系膜基质面积 /系膜面积 ) ,逆转录PCR检测FNmRNA表达 ,收集 2 4h尿测定尿白蛋白排泄率 (UAE)。结果　NF κB活性在B组大鼠肾组织 [(1 85± 0 54)× 1 0 6 ]显著高于A组 [(0 0 7± 0 1 1 )×1 0 6 ,P <0 0 1 ] ,C组 [(0 2 5± 0 2 5)× 1 0 6 ]显著低于B组 (P <0 0 1 )。B组与A组比较 ,UAE[(2 1 8±1 98)mgvs (0 41± 0 47)mg ,P <0 0 1 ]、肾小球基底膜厚度 [(531 6± 1 0 7 6)nmvs (31 2 4± 2 5 4)nm ,P<0 0 1 ]及系膜基质密度 [(56 41± 6 78)vs (33 95± 5 2 2 ) ,P <0 0 1 ]均有显著差异 ;UAE(0 56± 0 72 )mg、肾小球基底膜厚度 (31 5 8± 2 1 4)nm及系膜基质密度 (37 97± 7 37)在C组均显著低于B组 (P值均 <0 0 1 )。FNmRNA表达在B组大鼠肾组织 (0 73± 0 2 6)显著高于A组 (0 31± 0     

金属蛋白酶-2和金属蛋白酶组织抑制物-1与糖尿病肾病关系的实验研究

目的　观察链脲佐菌素 (STZ)实验性糖尿病大鼠肾脏基质金属蛋白酶 2 (MMP 2 )及金属蛋白酶组织抑制物 1(TIMP 1)蛋白的表达及功能、形态学改变 ,探讨MMP 2、TIMP 1在糖尿病肾病(DN)发生机制中的意义。　方法　 2 0只雄性Wistar大鼠随机分为糖尿病组和正常对照组 ,分别于第1、2、4、6、8周测定尿白蛋白排泄率 (UAER) ,第 9周用Western印迹方法检测MMP 2、TIMP 1蛋白表达水平 ,电镜观察肾小球基底膜厚度 (GBMT)。　结果　糖尿病组较正常组TIMP 1蛋白表达明显增加 ,MMP 2蛋白表达显著降低 (P <0 .0 1)。 4、6、8周UAER显著增加 ,GBMT明显增厚 (P <0 .0 1)。电镜发现糖尿病组肾小球基底膜弥慢性增厚 ,局部有系膜细胞插入和双轨征。　结论　持续高血糖可使大鼠肾脏MMP 2下降 ,TIMP 1增加。导致肾小球基底膜增厚 ,UAER增加。MMP 2、TIMP 1失衡可能对糖尿病肾病功能和形态学改变有重要意义。     

MT1-MMP、MMP-2和TIMP-2基因在去卵巢大鼠成骨细胞中的表达

目的　通过观察去卵巢 (OVX)骨质疏松模型大鼠成骨细胞膜型基质金属蛋白酶 1(MT1 MMP)基因的表达 ,探讨绝经后骨质疏松的发病机制。　方法　对OVX大鼠与假手术大鼠进行骨密度和骨组织形态计量学测定。股骨远端行原位杂交检测骨组织MT1 MMP、MMP 2和TIMP 2mRNA表达 ,免疫组化检测骨组织MT1 MMP、MMP 2和TIMP 2蛋白质表达。　结果　OVX大鼠第 3、4腰椎骨密度 (0 14 4± 0 0 11) g cm2 、(0 14 3± 0 0 15 ) g cm2 较对照组 (0 15 8± 0 0 18)g cm2 、(0 16 2± 0 0 17) g cm2 明显减少 ,OVX组骨小梁面积 (9 5 8± 3 39) %、厚度 (40 85± 8 0 4 ) μm和数目 (2 30± 0 4 8)个 mm分别较对照组 (2 0 6 3± 4 8) %、(44 73± 6 8) μm、(4 6± 0 7)个 mm明显下降 ,OVX组骨小梁间隔 (5 85 8± 115 1) μm较对照组 (2 5 4 6± 4 8 0 ) μm明显增宽 ;成骨细胞MT1 MMPmRNA与蛋白质表达下调 ,而MMP 2和TIMP 2之间表达无差异。　结论　雌激素不足可使成骨细胞MT1 MMP基因表达减少 ,可能为绝经后骨质疏松的发病机制之一。     

洛沙坦对大鼠糖尿病模型肾脏转化生长因子βⅠ型、Ⅱ型受体表达的影响

目的　观察洛沙坦对大鼠糖尿病模型肾脏转化生长因子 βⅠ型受体 (TGFβRⅠ )、Ⅱ型受体 (TGFβRⅡ )表达的影响。 方法　 30只大鼠按体重随机分为 3组 ,每组 10只。A组 :健康对照组 ;B组 :糖尿病模型组 ,尾静脉注射链脲佐菌素 5 0mg/kg体重制成糖尿病模型 ;(3)C组 :洛沙坦治疗组 ,按B组方法建立大鼠糖尿病模型后第 2天给予洛沙坦 10mg·kg体重 -1·d-1灌胃。 8周后半定量逆转录 聚合酶链反应检测 3组肾皮质TGFβRⅠ、TGFβRⅡ和纤维连接蛋白 (FN)mRNA的表达。免疫组化测 3组肾皮质TGFβRⅠ、TGFβRⅡ和FN蛋白的表达。生化法测血糖、尿素氮和肌酐水平。放射免疫法测血胰岛素和血管紧张素Ⅱ。磺基水杨酸法测 2 4h尿蛋白。结果　B组大鼠平均肾小球体积、肾重 /体重增加 ,2 4h尿蛋白、血尿素氮和肌酐水平上升 (P <0 0 5 ) ;肾皮质TGFβRⅠ、TGFβRⅡ、FNmRNA和蛋白表达显著增加 (P <0 0 5 )。C组大鼠平均肾小球体积、肾重 /体重减少 ,2 4h尿蛋白、血尿素氮和肌酐水平下降 (P <0 0 5 ) ;肾皮质TGFβRⅠ、TGFβRⅡ、FNmRNA和蛋白表达显著降低 (P <0 0 5 )。 结论　洛沙坦下调大鼠糖尿病模型肾脏TGFβRⅠ、TGFβRⅡ的表达 ,抑制肾脏细胞肥大 ,减少细胞外基质成分的合成。     

羟苯磺酸钙对糖尿病大鼠肾小球MMP9/TIMP1的影响

目的 观察羟苯磺酸钙对糖尿病(DM)大鼠肾小球基质金属蛋白酶9(MMP9)、金属蛋白酶组织抑制因子1(TIMP1)、胶原Ⅳ以及肾小球基底膜超微结构的影响。方法 糖尿病模型由Spregue-Dawley(SD)大鼠单肾切除联合腹腔注射链脲佐菌素(STZ)诱导,糖尿病给药组(DD组)每天给予羟苯磺酸钙100mg／kg。12周后观察各组大鼠肾脏超微结构的改变以及免疫组化检查肾组织MMP9、TIMP1和胶原Ⅳ表达的变化。结果 12周后电镜检查显示DD组肾小球毛细血管基底膜增厚轻于糖尿病对照组(DM组),无胶原纤维的增生,内皮细胞孔距不及单肾切除对照组(NC组)均匀,但较DM组均匀,足细胞突起排列尚整齐,免疫组织化学显示DD组TIMP1、胶原Ⅳ明显低于DM组。结论 羟苯磺酸钙能抑制胶原Ⅳ过度积聚、减轻肾小球基底膜增厚,这可能与抑制糖尿病大鼠肾脏TIMP1表达、上调MMP9／TIMP1比值有关。     

1型糖尿病大鼠肾脏Ⅳ型胶原的表达及坎地沙坦的干预作用

目的 探讨1型糖尿病大鼠造模后肾脏Ⅳ型胶原的表达及肾小球病理形态改变及坎地沙坦的保护作用和机制.方法 雄性Wistar大鼠36只,随机分出正常对照组(NC组)12只,余24只腹腔注射链脲佐菌素诱导糖尿病大鼠模型,再随机分为糖尿病组(DM组)12只和坎地沙坦干预组(DMC组)12只;DM-C组给予坎地沙坦5 mg·kg-1·d-1灌胃.干预12 w后,检测各组大鼠的空腹血糖(FPG)、血压、24 h尿白蛋白排泄量(24 h UAE)、肌酐清除率(Ccr)、肾重指数(KI);光镜下观察肾小球病理形态改变,测定肾小球平均截面积(MGA)、肾小球平均体积(MGV)和肾小球系膜基质分数(MMF);免疫组化法检测肾小球Ⅳ型胶原的表达.结果 与NC组相比,DM组大鼠的FPG、24 h UAE、Ccr及KI均显著升高(P＜0.01),MGA、MGV及MMF显著增大(P＜0.01),肾小球Ⅳ型胶原的表达明显增加(P＜0.01);DMC组较DM组肾小球Ⅳ型胶原的表达明显减少(P＜0.01),FPG、24 h UAE、Ccr及KI均显著降低(P＜0.01),MGA、MGV及MMF显著减小(P＜0.01);三组间大鼠血压差异无统计学意义(P＞0.05).结论 糖尿病大鼠肾脏Ⅳ型胶原表达增加;坎地沙坦具有独立于降压以外的肾脏保护作用.     

洛沙坦对糖尿病大鼠肾脏转化生长因子-β1及其Ⅱ型受体表达的影响及机制

目的　探讨血管紧张素Ⅱ(AngⅡ)受体拮抗剂洛沙坦对糖尿病 (DM )大鼠肾脏的保护作用及其作用机制。　方法　大鼠随机分为正常对照组 (C组 )、糖尿病组 (DM组 )和DM洛沙坦治疗组 (DL组 ) ,每组 10只。观察 8周后用半定量RT PCR检测各组肾皮质转化生长因子 βⅡ型受体 (TβRⅡ)和纤维连接蛋白 (FN)mRNA的表达。用免疫组化检测各组肾皮质转化生长因子 β1(TGF β1)、TβRⅡ和FNmRNA的表达。检测血糖 (BG )、尿素氮 (BUN )、肌酐 (Cr)、血胰岛素 (Ins)、AngⅡ、尿白蛋白排泄率(UAER)。　结果　DM组 8周出现平均肾小球体积、肾重 /体重增加 ,UAER、血BUN和Cr水平上升(P <0 .0 5)。DM组肾皮质TβRⅡ和FNmRNA的表达明显增加 ,TGF β1、TβRⅡ和FNmRNA的表达也显著增加 (P <0 .0 5)。洛沙坦治疗 8周后 ,DL组平均肾小球体积、肾重 /体重减少 ,UAER、血BUN和Cr水平下降 (P <0 .0 5)。肾皮质TβRⅡ和FNmRNA的表达降低 ,TGF β1、TβRⅡ和FNmRNA的表达也降低 (P <0 .0 5)。　结论　洛沙坦对DM大鼠肾脏具有保护作用。其机制可能为洛沙坦下调TGF β系统的表达 ,后者抑制肾细胞肥大、减少细胞外基质 (ECM)成分的合成     

雷帕霉素对糖尿病肾病大鼠病理结构及结缔组织生长因子表达的影响

目的 观察雷帕霉素对糠尿病肾病(DN)的保护作用.方法 应用链脲佐菌素(STZ)建立糖尿病大鼠模型.24只SD大鼠随机分为3组:对照组、糖尿病组、雷帕霉素组.第5周起雷帕霉素组予雷帕霉素1 mg·kg-1·d-1干预8 w.12 w末观察各组大鼠血糖、内生肌酐清除率(Ccr)、24 h尿微量白蛋白(24hUalb)、肾重/体重等的变化.光镜观察肾组织病理变化并测定肾小球平均体积及系膜基质扩张指数(EMMI).RT-PCR及免疫组化法检测肾皮质结缔组织生长因子(CTGF)mRNA及蛋白表达.结果 与对照组相比,糖尿病组及雷帕霉素组大鼠血糖、Ccr、24hUalb均显著上升,大鼠肾脏明显肥大,肾小球平均体积、EMMI、毛细血管基底膜厚度均显著增加;肾皮质CTGFmRNA及蛋白表达显著上调.雷帕霉素干预后,上述指标除血糖外均部分被抑制.结论 小剂量雷帕霉素能够减轻肾脏肥大,抑制系膜外基质聚集,下调CTGF的表达,延缓DN的进展.     

洛沙坦对糖尿病大鼠肺泡毛细血管膜的影响

目的　观察洛沙坦是否可改善糖尿病大鼠肺泡毛细血管膜的损害。方法　将 30只Wistar大鼠分为正常对照组、糖尿病对照组和糖尿病治疗组。糖尿病对照组和糖尿病治疗组大鼠以一次腹腔注射链脲佐菌素 (60mg/kg体重 )制成糖尿病模型。成模 3个月后给糖尿病治疗组大鼠每日洛沙坦 (3mg/kg体重 )灌胃 3个月。实验末分别测定血清和肺组织匀浆的血管紧张素转换酶 (ACE)活性 ,并以透射电镜观察肺泡毛细血管膜的变化。结果　糖尿病对照组大鼠肺间质中胶原增生 ,肺泡毛细血管内皮细胞基板和肺泡上皮细胞基板的融合部分 (FBL)比正常对照组明显增厚〔(1 99.2± 2 3.5)nmvs (1 1 9.9± 2 7.8)nm ,P<0 .0 1〕 ,血清和肺组织匀浆ACE活性也明显高于正常对照组 ;糖尿病治疗组大鼠与糖尿病对照组比较 ,肺间质中胶原略有减少 ,FBL的增厚减轻〔(1 4 7.0± 2 4 .4)nm ,P <0 .0 5〕 ,而其血清和肺组织匀浆的ACE活性与正常对照组相比 ,差异已无显著性。结论　洛沙坦对糖尿病大鼠的肺泡毛细血管膜具有保护作用     

糖尿病大鼠肾脏一氧化氮变化与肾小球硬化及非酶糖化的关系

肾小球硬化为糖尿病肾病 (DN)的病理改变 ,其基本病变为肾小球基底膜增厚和系膜基质的增生。糖尿病 (DM)肾组织胶原蛋白非酶糖化是 DM肾小球硬化重要的原因之一 [1 ,2 ]。有研究表明一氧化氮 (NO)具有抑制肾小球系膜细胞外基质积聚的作用 ,而蛋白非酶糖化致糖基化终产物 (AGE)的大量形成则阻碍了 NO的抗细胞增殖作用 [3 ]。本实验通过观察链脲佐菌素(STZ)诱导的 DM大鼠在不同病程肾组织 NO含量和一氧化氮合酶 (NOS)活性、AGE、胶原含量及肾组织形态学变化 ,探讨DN发病的相关机制。材料和方法1.材料 :选择体重 15 0～ 2 0 0 g的…     

Research and Evaluation of the Influence of the Construction of the Gate and the Influence of the Piston Velocity on the Distribution of Gases into the Volume of the Casting

Distribution of gasses to the cast volume and volume of pores can be maintained within the acceptable limits by means of correct setting of technological parameters of casting and by selection of suitable structure and gating system arrangement. The main idea of this paper solves the issue of suitability of die casting adjustment—i.e., change of technological parameters or change of structural solution of the gating system—with regards to inner soundness of casts produced in die casting process. Parameters which were compared included height of a gate and velocity of a piston. The melt velocity in the gate was used as a correlating factor between the gate height and piston velocity. The evaluated parameter was gas entrapment in the cast at the end of the filling phase of die casting cycle and at the same time percentage of porosity in the samples taken from the main runner. On the basis of the performed experiments it was proved that the change of technological parameters, particularly of pressing velocity of the piston, directly influences distribution of gasses to the cast volume.     

Weighing the QT Intervals with the Slope or the Amplitude of the T Wave

Objective: The reproducibility of QT interval measurements is low, even for the mean QT interval based on the standard ECG. In this study we analyzed whether the reproducibility of the mean weighed QT interval was better than the simple mean QT interval. The weighing was based on the amplitude of the T wave or the slope of the steepest tangent on the terminal part of the T wave. Material and methods: 12‐lead ECGs of 130 postmyocardial infarction patients were obtained. The QT intervals were measured by the tangent‐method on two occasions by the same observer Mismatch QT intervals were defined as QT intervals that were measured at only one occasion. Sixteen ECGs were rejected. The data were split into 34 and 80 ECGs for optimization and validation of the weighing, respectively. The weighed QT dispersion was calculated as the weighed mean of the three longest minus the weighed mean of the three shortest QT intervals. Results: Weighing with the slope increased the reproducibility by 41% (P = 3 10^‐6), but weighing with the amplitude reduced it by 20% (P = 0.02). However, if measurements with errors above 75 ms were rejected, weighing with the slope or the amplitude increased the reproducibility with 26% and 20% (P = 0.02), respectively. Weighing did not change the reproducibility of the weighed QT dispersion. Conclusion: Weighing with the slope improved the reproducibility of the mean weighed QT interval. However, if measurements with errors above 75 ms were rejected, weighing with the amplitude also increased the reproducibility. Weighing did not change the reproducibility of the weighed QT dispersion. Weighing is particularly efficient at reducing the negative impact of mismatch QT intervals on the reproducibility. A.N.E. 2002;7(1):4–9     

县级以下综合医疗机构医务人员对现代结控知识的认识现状调查

目的本文旨在了解医务人员现代结控知识掌握的现状及培训效果?方法于培训前后进行问卷调查,内容包括:病例发现?结核病诊断及化疗?结果培训前疫情报告和转诊,回答正确者占75.2%?71.7%;对临床表现?查痰和诊断依据,回答正确者占83.5%?42.5%?40.8%;抗痨药物?用药方法?化疗原则?短化方案?短化疗程?治愈标准六项,回答正确者占58%?14.4%?20.8%?9.2%?17%?24.3%?培训后再次调查发现,90%以上医务人员对现代结控基本知识已掌握?结论各级医务人员现代结控知识是很贫乏的,因此,对其进行系统培训是极为必要的,此项工作省时?省力?投入少,可收到事半功倍的效果。     

大骨节病病区水,粮实验对动物的骨和软骨中化学元素组成的影响

用质子激发 X 线荧光分析方法(PIXE)测定了大骨节病病区和非病区的水、粮以及用该水粮喂养的大白鼠的肋软骨和硬骨中22种化学元素的含量。结果发现水粮中存在差异的元素反应在用该水粮喂养的大白鼠的骨、软骨中也存在差异,含量都低的元素有 P、Mn、Cu、As、Zn。都高的有铅。其中锌低在水、粮、硬骨和软骨中都完全一致呈非常显著性差异(p<0.01)。提示病区水、粮中化学元素对骨质的影响不是单一元素缺乏或过多所致,而是多种元素的复合因素。     

Assessment of the Soft-Tissue Seal at the Interface between the Base of the Fixed Denture Pontic and the Oral Mucosa

Fixed dentures (bridges) are often selected as a treatment option for a defective prosthesis. In this study, we assess the contact condition between the base of the pontic and oral mucosa, and examine the effect of prosthetic preparation and material biocompatibility. The molars were removed and replaced with experimental implants with a free-end type bridge superstructure after one week. In Experiment 1, we assessed different types of prosthetic pre-treatment: (1) the untreated control group (Con: mucosa recovering from the tooth extraction); (2) the laser irradiation group (Las: mucosa recovering after the damage caused by a CO₂ laser); and (3) the tooth extraction group (Ext: mucosa recovering immediately after the teeth extraction). In Experiment 2, five materials (titanium, zirconia, porcelain, gold-platinum alloy, and self-curing resin) were placed at the base of the bridge pontic. Four weeks after the placement of the bridge, the mucosa adjacent to the pontic base was histologically analyzed. In Experiment 1, the Con and Las groups exhibited no formation of an epithelial sealing structure on the pontic base. In the Ext group, adherent epithelium was observed. In Experiment 2, the sealing properties at the pontic interface were superior for titanium and the zirconia compared with those made of porcelain or gold-platinum alloy. In the resin group, a clear delay in epithelial healing was observed.     

高胆红素血症对肿瘤标志物测定的影响探讨

目的探讨高胆红素血症对Ca19-9、Ca24-2和CEA检测的影响.方法对320例胆管、胆囊良恶性疾病病人,15例胆囊炎病人的胆汁和血清以及10例肝硬化、10例黄疸肝炎病人进行Ca19-9、Ca24-2和CEA检测.结果在良性胆管、胆囊疾病中,Ca19-9的假阳性最高;在胆红素增高的良性疾病中,Ca19-9假阳性率达46.7%;15例胆汁和血清以及10例肝硬化和10例黄疸肝炎病人中,Ca19-9的假阳性率分别为93%、20%、80%和80%.结论高胆红素血症对Ca19-9检测影响最明显,胆囊、胆管良恶性疾病鉴别时,以Ca24-2和CEA检测为佳.     

Echocardiography in the Emergency Department: From the Perspective of the Emergency Physician and the Cardiologist

Echocardiography performed in the emergency department must adapt to this new setting for noninvasive diagnostic testing. Emergency physicians require echocardiography to provide rapid diagnosis in life-threatening emergencies. New initiatives are being proposed by emergency physicians in the delivery of this test. Cardiologists now use echocardiography in the emergency-department to make the diagnosis of heart disease earlier and with greater accuracy.