金雀异黄素对大鼠胸主动脉舒张功能的影响及其机制

目的观察植物雌激素金雀异黄素(genistein,GST)的快速舒张血管效应,并探讨其作用机制。方法选择雌性SD大鼠30只,取胸主动脉后,每条制成4个血管环(共120个血管环),采用血管张力仪进行体外血管灌注实验,测量不同浓度GST和17β-雌二醇(E2)大鼠体外胸主动脉环等长张力;另将血管按不同实验分为4组:对照组、左旋硝精氨酸甲酯(L-NAME)组、他莫昔芬(TAM)组和过氧化物酶体增殖物激活受体γ(PPARγ)组,并测量各组血管环张力。结果不同浓度GST(10-9~10-6mol/L)对苯肾上腺素(10-6mol/L)预收缩的血管环能产生浓度依赖性快速舒张血管效应,其作用与E2相似。与对照组比较,L-NAME组、TAM组、PPARγ组均能抑制GST的舒张血管效应。结论GST的快速舒张血管效应主要与内皮释放的NO有关,部分与PPARγ的调节作用有关,并通过雌激素受体发挥作用。     

Association of serum nesfatin-1 concentrations with atrial fibrillation

Nesfatin-1, a newly discovered adipokine, inhibits inflammatory response. Inflammation is involved in the mechanism of atrial fibrillation (AF). We aim to determine the association between serum nesfatin-1 concentrations and AF. A population of 200 patients with AF and 108 patients without AF were enrolled in this study. These patients were divided into three subgroups of paroxysmal AF, persistent AF, and permanent AF. Serum nesfatin-1 concentrations were lower in AF patients than in controls. Logistic regression analysis showed that serum nesfatin-1 concentrations were inversely associated with AF. Serum nesfatin-1 concentrations in permanent AF patients decreased compared with those in persistent and paroxysmal AF groups. In addition, persistent AF patients showed reduced serum nesfatin-1 concentrations compared with paroxysmal AF subjects. Serum nesfatin-1 concentrations were negatively correlated with left atrial diameter. In conclusion, serum nesfatin-1 concentrations were inversely correlated with AF development.     

Percutaneous stenting of acquired thoracic aorta occlusive disease.

We report on successful treatment of acquired atherosclerotic coarctation of the thoracic aorta with self-expanding stents via percutaneous approach. The technique and equipment used in the case are discussed.     

Nesfatin-1与肥胖的关系

Nesfatin-1是一种新发现的摄食抑制性脑肠肽,在中枢神经系统和多个外周组织中均有表达.Nesfatin-1基因多态性或蛋白表达异常均可能引发摄食增多和肥胖.Nesfatin-1可直接作用于摄食相关神经元,减轻肥胖程度;也可通过影响催产素、神经肽Y等神经肽的表达和功能,间接发挥降低体重的作用.     

高山红景天乙醇提取液对大鼠离体胸主动脉环的舒张作用及机制探讨

目的观察高山红景天乙醇提取液对大鼠离体胸主动脉环的舒张作用,并探讨其机制。方法离体大鼠主动脉环,先用1.0 mmol/L苯肾上腺素（PE）和50 mmol/LKCl预收缩,然后加入0.5、1.0、2.0 mg/ml高山红景天乙醇提取液,调其终浓度为0.5、1.0、2.0 mg/ml,记录胸主动脉环张力变化。结果高山红景天乙醇提取液对PE和KC l预收缩的内皮完整的大鼠主动脉环有浓度依赖性的舒张作用。在无钙缓冲液（含EGTA）环境下,红景天预处理对PE导致的血管收缩有明显抑制作用。结论 高山红景天乙醇提取液可舒张大鼠离体主动脉环,其机制与其抑制血管平滑肌细胞内质网储存钙的释放有关。     

不同糖耐量人群血清nesfatin-1水平及相关因素分析

目的 研究不同糖耐量人群血清nesfatin-1水平变化,及其与体重指数(BMI)、血糖、胰岛素敏感性等的关系.方法 115例研究对象分为正常糖耐量组(NGT组,33例)、糖耐量减低组(IGT组,30例)和新诊2型糖尿病组(T2DM组,52例)3组.根据BMI将T2DM组分为糖尿病肥胖组(T2DM-OB组,22例)和糖尿病正常体重组(T2DM-NW组,30例).采用ELISA法检测血清nesfatin-1水平.同时测定空腹血糖(FPG)、餐后2h血糖(2 h PG)、白细胞介素-6(IL-6)、胰岛素、糖化血红蛋白A1c(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C).T2DM-OB组给予吡格列酮治疗,使仅BMI高于T2DM-NW组(P＜0.05)后再次检测血清nesfatin-1水平.计算稳态模型评估-胰岛素抵抗指数(HOMA-IR)、BMI、腰臀比(WHR)等.结果(1)T2DM组和IGT组血清nesfatin-1水平显著高于NGT组[(1 780±660) ng/L,(1 620±590) ng/Lvs.(1 390±610) ng/L,P＜0.05].(2)T2DM-OB组血清nesfatin-1水平显著高于T2DM-NW组[(1 897±670) ng/L vs.(1 690±650)ng/L,P＜0.05],经吡格列酮治疗后T2DM-OB组nesfatin-1水平仍高于T2DM-NW组[(1 791±634) ng/L vs.(1 690 ±650)ng/L,P＜0.05].(3)Nesfatin-1水平与TG、FPG、2hPG、HbA1c、IL-6、HOMA-IR、BMI呈正相关(r=0.582,0.568,0.587,0.552,0.546,0.523,0.562).多元逐步回归分析显示,HOMA-IR、FPG、BMI与血清nesfatin-1水平独立相关.结论 随着糖耐量受损程度的加重及肥胖的发生,nesfatin-1水平逐渐升高,nesfatin-1可能在肥胖及糖耐量受损中发挥重要作用.     

Penetrating ulcer of ascending thoracic aorta in syphilis.

Penetrating aortic ulcers (PAUs) are rare exotic pathological entities, classically located in the descending thoracic aorta. Their association with syphilis has never been reported. We describe a first case of a patient with cardiovascular syphilis presenting as PAU in the ascending aorta.     

Significance of the intima-media thickness of the thoracic aorta in patients with coronary atherosclerosis

BACKGROUND: The prevalence and clinical significance of atherosclerotic aortic disease have now been documented in a variety of patient populations by use of transesophageal echocardiography (TEE). There are many reports that atherosclerotic aortic plaques detected by TEE are a marker for coronary artery disease (CAD). HYPOTHESIS: The study was undertaken to evaluate the significance of the intima-media thickness (IMT) and formation of atherosclerotic plaques of the thoracic aorta (TA) in patients with CAD, especially in terms of a correlation between the IMT of the TA and the extent of coronary atherosclerosis. METHODS: The IMT of the TA was measured using TEE. The study population comprised 100 patients (68 men, mean age 59 years). The extent of coronary atherosclerosis was divided into four groups (0, 1, 2, 3) according to the number of coronary arteries narrowed > or = 50%. RESULTS: There was no significant difference in the IMT of the ascending TA according to the presence of significant (> 50% narrowed) coronary stenosis, but there was a significant difference in the IMT of the descending TA (1.39 vs. 1.88 mm, p = 0.005). There was a significant correlation between the extent of coronary atherosclerosis and the IMT of the ascending and descending TA (r = 0.24, p < 0.05; r = 0.352, p < 0.001, respectively). The plaques in the TA were seen in 7, 41, 52, and 65% of patients in Groups 0, 1, 2, and 3, respectively. Among atherosclerosis risk factors, hyperlipidemia was the only factor analyzed that affected the IMT of the descending TA (2.11 vs. 1.78 mm, p < 0.05). CONCLUSION: The IMT of the TA correlates significantly with coronary atherosclerosis, and correlation of the descending TA IMT with coronary atherosclerosis is better than that of ascending TA IMT. Age is associated with coronary atherosclerosis, and TA IMT and hyperlipidemia are associated with descending TA IMT. Therefore, although TEE is not recommended for measuring TA IMT or for evaluating aortic plaques in patients with CAD, measurement of TA IMT as well as carotid artery IMT is very helpful for understanding the extent of coronary atherosclerosis.     

Expression of nesfatin-1/NUCB2 in rodent digestive system

AIM: To observe the regional distributions and morphological features of nesfatin-1/nucleobindin-2 (NUCB2) immunoreactive (IR) cells in the rodent digestive system. METHODS: Paraffin-embedded sections of seven organs (pancreas, stomach, duodenum, esophagus, liver, small intestine and colon) dissected from sprague-dawley (SD) rats and institute of Cancer Research (ICR) mice were prepared. The regional distributions of nesfatin-1/NUCB2 IR cells were observed by immunohistochemical staining. The morphological ...     

模拟失重大鼠胸主动脉平滑肌细胞凋亡的变化及间断性人工重力对抗的影响

目的:观察模拟失重大鼠胸主动脉平滑肌细胞凋亡的变化及间断性人工重力对其影响。方法: 将27只SD大鼠随机分为3组（每组9只）,即对照组(CON)、模拟失重组(SUS)及站立对抗组(STD)。以尾部悬吊大鼠模拟失重3周,同期每天悬吊23 h、站立1 h模拟间断性人工重力对抗的效果。用TUNEL染色法检测SUS组、同步对照(CON)组及STD组大鼠胸主动脉平滑肌细胞的凋亡情况;用Western blot法检测各组大鼠胸主动脉组织中Bad、FasL及Caspase-3蛋白表达的变化。结果: 与CON组比较,SUS组大鼠胸主动脉平滑肌细胞TUNEL染色阳性的细胞明显减少(P<0.01);STD组TUNEL染色阳性的细胞较CON组及SUS组显著增加（P<0.01）。SUS组Bad的表达较CON组和STD组显著减少（P<0.05）,STD组Bad的表达较CON组有增加的趋势,但无统计学差异。SUS组FasL及Caspase-3的表达较CON组显著降低(P<0.05);STD组FasL及Caspase-3的表达较CON组及SUS组显著增高(P<0.01)。结论: 模拟失重可减少大鼠胸主动脉平滑肌细胞凋亡,每日1 h的-Gx对抗可使胸主动脉平滑肌细胞的凋亡增加,提示血管组织平滑肌细胞的凋亡在失重引起的动脉血管适应性重构中可能发挥重要作用。     

Role of nesfatin-1 in a rat model of visceral hypersensitivity

AIM: To explore the role of nesfatin-1 on irritable bowel syndrome (IBS)-like visceral hypersensitivity. METHODS: The animal model of IBS-like visceral hypersensitivity was induced by intracolonic infusion of 0.5% acetic acid (AA) in saline once daily from postnatal days 8-21. Experiments were performed when rats became adults. The visceral sensitivity of rats was evaluated by abdominal withdrawal reflex (AWR) and electromyographic (EMG) activity of the external oblique muscle to graded colorectal distension. The content of nesfatin-1 in serum was determined using enzyme-linked immunosorbent assay. After implantation of an intracerebroventricular (ICV) cannula and two electrodes into the external oblique muscle, model rats were randomly divided into four groups. Animals then received ICV injection of 8 μg of anti-nesfatin-1/ nucleobindin-2 (NUCB2), 50 μg of α-helical cortico-tropin releasing factor (CRF) 9-41 (non-selective CRF receptor antagonist), 50 μg of NBI-27914 (selective CRF1 receptor antagonist) or 5 μL of vehicle. After 1 h of ICV administration, visceral sensitivity of each group was measured again, and comparisons between groups were made. RESULTS: Rats treated with AA showed higher mean AWR scores and EMG activity at all distension pressures compared with controls (P < 0.05). On histopathologic examination, no evidence of inflammation or abnormalities in structure were noted in the colon of either control or AA-treated groups. Myeloperoxidase values were not significantly different between the two groups. The level of nesfatin-1 in serum was significantly higher in the AA-treated group than in the control group (5.34 ± 0.37 ng/mL vs 4.81 ± 0.42 ng/mL, P < 0.01). Compared with rats injected with vehicle, rats which received ICV anti-nesfatin-1/NUCB2, α-helical CRF9-41 or NBI-27914 showed decreased mean AWR scores and EMG activity at all distension pressures (P < 0.05). CONCLUSION: Nesfatin-1 may be associated with IBS-like visceral hypersensitivity, which may be implicated in brain C     

血小板源生长因子对离体大鼠胸主动脉血管张力的影响

目的 :观察血小板源生长因子对主动脉血管环舒缩作用的影响。方法 :采用离体灌流SD大鼠胸主动脉血管环标本 ,观察不同浓度的血小板源生长因子 BB（PDGF BB）对大鼠胸主动脉血管环的舒缩作用的影响 ,并与去甲肾上腺素 （NE）作对比。结果 :PDGF BB对大鼠胸主动脉有明显的收缩作用 ,阈浓度为 2× 10 -10 mol/L ,且呈现出一种浓度依赖关系 ;与NE相比 ,PDGF BB对血管的收缩幅度低于NE ,但其收缩血管的活性高于NE。PDGF BB对去内皮的血管同样产生收缩作用 ,鱼精蛋白可抑制PDGF BB收缩大鼠的胸主动脉的作用。结论 :PDGF BB对大鼠胸主动脉有明显的收缩作用 ,且呈现出一种浓度依赖关系 ,其血管收缩作用为非内皮依赖性收缩作用 ,鱼精蛋白可抑制PDGF BB收缩血管的作用。     

糖调节受损和2型糖尿病患者血浆nesfatin-1水平的变化

采用酶联免疫法测定了初诊2型糖尿病患者、糖调节受损(IGR)患者、正常糖耐量(NGT)者血浆nesfatin-1水平.结果显示,2型糖尿病和IGR组血浆nesfatin-1水平明显高于NGT组[(1.91±0.79和1.80±0.80对1.41±0.58)μg/L,P＜0.01].血浆nesfatin-1水平与体重指数(BMI)、空腹血糖、空腹胰岛素、HbA1C、稳态模型评估的胰岛素抵抗指数(HOMA-IR)呈明显正相关(P＜0.05或P＜O.01).多元回归分析结果表明HOMA-IR和BMI分别是影响血浆nesfatin-1水平的独立相关因素(均P＜0.01).提示血浆nesfatin-1可能参与了胰岛素抵抗和2型糖尿病的发生和发展.     

Different clinical features of aortic intramural hematoma versus dissection involving the descending thoracic aorta

OBJECTIVE: The objective of this study is to test the hypothesis that the absence of flow communication in aortic intramural hematoma (IMH) involving the descending aorta may have a different clinical course compared with aortic dissection (AD). METHODS: We prospectively evaluated clinical and echocardiographic data in AD (76 patients) and IMH (27 patients) of the descending thoracic aorta. RESULTS: Patients did not differ with regard to age, gender, or clinical presentation. IMH and AD had the same predictors of complications at follow-up: aortic diameter (>5 cm) at diagnosis and persistent back pain. Surgical treatment was more frequently selected in AD (39% vs. 22%, P < 0.01) and AD patients who underwent surgical treatment had higher mortality than those with IMH (36% vs. 17%, P < 0.01). There was no difference in mortality with medical treatment (14% in AD vs. 19% in IMH, P = 0.7). During follow-up, of 23 patients with IMH, 11 (47%) showed complete resolution or regression, 6 (26%) increased the diameter of the descending aorta, and typical AD developed in 3 patients (13%). No changes occurred in 14% of the group. Three-year survival rate did not show significant differences between both groups (82 +/- 6% in IMH vs. 75 +/- 7% in AD, P = 0.37). CONCLUSION: IMH of the descending thoracic aorta has a relatively frequent rate of complications at follow-up, including dissection and aneurysm formation. Medical treatment with very frequent imaging and timed elective surgery in cases with complications allows a better patient management.     

nesfatin-1/NUCB2在人及鼠类动物消化系统的表达

目的 探讨一种新的摄食调节肽nesfatin-1/NUCB2在人、SD大鼠及ICR小鼠消化系统的分布,为进一步研究其在消化系统的功能奠定形态学基础.方法 取20例南京医科大学附属第一医院因消化系统疾病而行手术者的手术切除标本共27个,SD大鼠及ICR小鼠的胰腺、胃、十二指肠、食管、肝、小肠、结肠组织.其中恶性肿瘤患者标本为距肿瘤5 cm以上的癌旁组织,良性肿瘤患者的标本为病变边缘组织.免疫组化检测nesfatin-1/NUCB2的分布状况,Western印迹检测NUCB2蛋白的含量.结果 免疫组化显示nesfatin-1/NUCB2免疫阳性细胞在人、SD大鼠和ICR小鼠消化系统中的表达部位大致相似,主要分布于胰腺胰岛的中央;胃黏膜腺下1/3至中1/2的内分泌细胞及十二指肠黏膜下层的布氏腺中.在人、SD大鼠和ICR小鼠组织中均检测到了NUCB2蛋白的表达,但胰腺(分别为0.84±0.03、0.84±0.05和0.84±0.04)、胃(分别为0.86±0.06、0.81±0.02和0.78±0.02)及十二指肠(分别为0.79±0.09、0.79±0.04和0.78±0.05)处的NUCB2蛋白含量显著高于食管(分别为0.43±0.04、0.44±0.02和0.47±0.06)、肝(分别为0.42±0.01、0.44±0.04和0.43±0.01)、小肠(分别为0.32±0.04、0.32±0.04和0.34±0.04)及结肠(分别为0.29±0.01、0.32±0.03和0.28±0.03)中的蛋白含量(P值均=0.000).结论 nesfatin-1/NUCB2这种新的摄食调节肽广泛存在于人、SD大鼠及ICR小鼠的胰岛、胃黏膜腺内分泌细胞及十二指肠布氏腺中,提示其在外周摄食调节、碳水化合物代谢及胃肠功能的调节方面存在一定的功能.

Abstract：

Objective To investigate the regional distribution and morphological features of nesfatin-1/NUCB2 in digestive system of the humans, Sprague-Dawley (SD) rats and the institute of cancer research (ICR) mice, so as to lay the foundation for further study of its functions in the digestive system. Methods The specimens were obtained from SD rats and ICR mice as well as 20 patients with digestive disease, who were admitted to the First hospital affiliated to Nanjing Medical University and receired surgercal treatment. The specimens from patients with malignant tumors were obtained 5 cm apart from cancerous tissues and from patients with benign tumors were obtained near the focus. The resected tissues included pancreas, stomach, duodenum, esophagus, liver, small intestine or colon. The distribution of nesfatin-1/NUCB2 was examined with immunohistochemical (IHC) staining and its protein level in each organ was measured using Western blotting. Results The immuinohistocemical study revealed the similar distribution pattern of nesfatin-1/NUCB2 in the digestive system of the patients, SD rats and ICR mice. Nesfatin-1/NUCB2 was found to localize in the center of the pancreatic islets, the lower 1/3 to 1/2 of the gastric mucosal glands, as well as the submucosa of the duodenum. Western blotting examination showed the expression of NUCB2 in all tissues from patients, SD rats and ICR mice, whereas the protein level of the nesfatin-1/NUCB2 was higher in pancreas (0.84±0.03, 0. 84±0.05 and 0. 84±0.04, respectively), stomach (0.86±0.06,0.81±0.02 and 0. 78±0.02, respectively) or duodenum (0.79±0.09,0. 79±0.04 and 0.78±0.05)than that in esophagus (0.43±0.04,0.44 ± 0.02 and 0.47 ± 0.06, respectively), liver (0.42±0.01,0.44±0.04 and 0.43 ± 0.01, objectively), small intestine (0.32±0.04,0. 32 ± 0. 04 and 0.34 ±0.04, respectively) or colon (0. 29±0.01,0.32±0.03 and 0. 28±0.03, respectively)(all P values=0. 000). Conclusion Nesfatin-1/NUCB2 is widely expressed in the pancreatic islets, gastric mucosal glands and duodenum of the patients, SD rats and ICR mice, which indicates that nesfatin-1/NUCB2 may be involved in the regulation of food intake, carbohydrate metabolism and gastrointestinal motility.     

Endovascular treatment of the malignant thrombus in the descending thoracic aorta

Thrombus in the Non-aneurysmal, Non-atherosclerotic Descending Thoracic Aorta (NAADTA) represents a rare source of peripheral arterial embolism. Despite being mostly asymptomatic process, its consequences can be very serious. In this case report, we described the case of a patient with malignant thrombus occurring in otherwise “healthy” descending thoracic aorta, already complicated by embolization into superior mesenteric artery, subsequently solved by stent graft implantation into the thoracic aorta.     

Assessment of elastic properties of the descending thoracic aorta by transesophageal echocardiography with acoustic quantification in patients with a stroke

Previous studies have described the use of transesophageal echocardiography (TEE) with acoustic quantification (AQ) in assessing aortic elastic properties. We hypothesized that patients with a prior history of stroke (ST) may have a higher risk of atherosclerotic change in great vessels compared to nonstroke subjects (NST) and thus have decreased elastic properties. We assessed the elastic properties of the descending thoracic aorta (DTA) by TEE in ST patients and compared them with data in NST patients. Subjects included 31 with ST without any evidence of emboli originating from the heart (age 51 +/- 10 years, M:F = 20:11) and 25 age-matched NST (M:F = 8:17). Patients with significant valvular heart disease including aortic and mitral regurgitation, left ventricular dysfunction (ejection fraction < 55%), and congenital heart disease were excluded. Compliance (C), distensibility (D), and stiffness index (SI) were measured using AQ and M-mode measurement at a level of the left atrium. We scored atherosclerotic risk factors (ARF) such as a history of diabetes, hypertension, smoking, hypercholesterolemia, and the presence of atheroma of DTA. There was no evidence of atheroma of DTA in NST. There were no significant differences in heart rate and systolic and diastolic blood pressure between ST and NST patients. Fractional area change (FAC) of DTA was significantly lower in ST than in NST patients (3.2 +/- 1.6 vs 5.4 +/- 2.5%, P = 0.000). ST patients had significantly lower C (1.2 +/- 0.4 vs 1.5 +/- 0.7 x 10(-3) cm2 mmHg(-1), P = 0.039), lower D (0.8 +/- 0.3 vs 1.5 +/- 0.8 x 10(-3) mmHg(-1), P = 0.000), and higher SI (10.3 +/- 8.8 vs 5.3 +/- 2.9, P = 0.006) than NST patients. ST patients without atheroma of DTA (n = 21) also had significantly lower C (1.1 +/- 0.4 vs 1.5 +/- 0.7 x 10(-3) cm2 mmHg(-1), P = 0.038) and lower D (3.5 +/- 1.4 vs 4.8 +/- 2.4 x 10(-3) mmHg(-1), P = 0.021) than NST patients. There was a significant positive correlation between SI and the score of ARF (r = 0.51, P = 0.000). The regional elastic properties of DTA measured by TEE with AQ and M-mode method were abnormal in ST. Therefore, TEE with AQ technique may have a possible clinical application for the detection of early atherosclerotic changes such as alteration of elastic properties in morphological normal DTA.