肥大细胞脱颗粒对载脂蛋白E基因敲除小鼠斑块稳定性的影响

目的 探讨肥大细胞脱颗粒对颈总动脉套环的载脂蛋白E基因敲除小鼠斑块稳定性的影响.方法 40只雄性载脂蛋白E基因敲除小鼠予以高脂高胆固醇饲料喂养,行右颈总动脉套环术,术后4周,随机分为实验组和对照组,实验组小鼠腹腔注射肥大细胞脱颗粒剂--化合物48/80(0.5 mg/kg),对照组小鼠腹腔注射相同体积的溶媒D-Hank's,隔日一次,共4次.第4次注射后30 min安乐死,取材.比色法测定血清类胰蛋白酶活性;甲苯胺蓝染色检测肥大细胞脱颗粒;苏木素-伊红染色观察颈总动脉病理改变及斑块内出血;Ⅷ因子相关抗原免疫组织化学染色检测斑块内新生血管密度;血管内皮钙粘蛋白、白细胞介素1β免疫组织化学染色检测其在斑块内的表达量.结果 实验组套环侧颈总动脉内膜下斑块内泡沫细胞、细胞外脂质及炎性细胞较对照组明显增多;实验组肥大细胞脱颗粒、血清类胰蛋白酶活性、斑块内新生血管密度、斑块内出血、斑块内白细胞介素1β及血管内皮钙粘蛋白的表达量比对照组显著增高(P<0.05或P<0.01).结论 肥大细胞脱颗粒增加斑块内泡沫细胞、细胞外脂质及炎性细胞,并促进斑块内血管新生、斑块内出血及白细胞介素1β和血管内皮钙粘蛋白的表达,从而使斑块稳定性削弱.     

化合物48/80对载脂蛋白E基因敲除小鼠主动脉斑块的影响

目的目前,肥大细胞与动脉粥样硬化的关系研究主要是病理学观察和细胞学实验。基于此种现状,本课题拟用化合物48/80探讨肥大细胞脱颗粒与载脂蛋白E基因敲除小鼠主动脉斑块的关系。方法40只10周龄载脂蛋白E基因敲除小鼠给予高脂高胆固醇饲养至16周龄,随机分为2组(n=20),实验组给予腹腔注射化合物48/80(0.5mg/kg),隔日一次,共4次;对照组腹腔注射Dhank’s。第4次注射后半小时,安乐死处死动物,摘眼球取血,分离血清,采用酶法测定血清脂质含量,采用比色法测定血清类胰蛋白酶活性浓度。原位灌流固定,取主动脉置10%中性缓冲福尔马林中固定,石蜡包埋,连续切片,HE染色、甲苯胺蓝染色以及α平滑肌肌动蛋白、Mac3、VEcadherin免疫组织化学染色。HMIAs2000高清晰度彩色医学图文分析系统进行图像分析。结果实验组血清类胰蛋白酶活性浓度明显高于对照组(0.57±0.13u/L比0.36±0.10u/L),但两组血清脂质含量无明显差异。实验组与对照组相比,主动脉外膜脱颗粒肥大细胞百分率升高(80.6%±17.8%比13.5%±4.1%,P<0.05),主动脉斑块最大横截面积增大[(1.25±0.36)×104μm2比(0.79±0.24)×104μm2,P<0.05],斑块内α平滑肌肌动蛋白阳性细胞百分率下降(36.2%±14.9%比69.7%±31.3%,P<0.05)斑块内Mac3阳性细胞百分率升高(58.6%±17.3%比28.5%±16.4%,P<0.05),而斑块内膜VEcadherin平均光密度减小(48±8比65±10,P<0.05)。结论化合物48/80促使肥大细胞脱颗粒,并使载脂蛋白E基因敲除小鼠主动脉斑块最大横截面积增大、斑块内Mac3阳性细胞百分率升高、α平滑肌肌动蛋白阳性细胞百分率下降、斑块内膜VEcadherin平均光密度减小。     

肥大细胞类胰蛋白酶促进动脉粥样硬化斑块内出血

目的体内外实验研究类胰蛋白酶在动脉粥样硬化斑块内出血中的作用。方法体外通过慢病毒载体干扰肥大细胞P815类胰蛋白酶表达,取培液上清作为条件培养基孵育小鼠微血管内皮细胞(bEnd.3),观察细胞增殖、迁移、管腔形成情况,Western blot检测PAI、tPA表达改变。体内实验利用ApoE-/-小鼠,右侧颈总动脉套环建立斑块内出血模型,随机分为6组:①肥大细胞脱颗粒剂;②肥大细胞稳定剂;③肥大细胞脱颗粒剂+类胰蛋白酶病毒载体;④肥大细胞稳定剂+对照病毒载体;⑤肥大细胞稳定剂+对照siRNA病毒载体;⑥肥大细胞稳定剂+siRNA病毒载体。小鼠处死后取颈动脉斑块,冷冻切片,荧光显微镜观察斑块内荧光表达,HE染色观察出血及血管新生状况,免疫组化染色检测PAI、tPA、CD31表达。结果过表达类胰蛋白酶P815条件培养基促进bEnd3细胞增殖、迁移能力以及管腔形成能力;而且促进bEnd3细胞tPA表达,同时抑制PAI表达。ApoE-/-小鼠体内过表达类胰蛋白酶后,未套环侧颈总动脉斑块面积增大,狭窄程度加重;套环侧斑块内出血加重,斑块内CD31表达增加;同时PAI表达降低、tPA表达升高。结论类胰蛋白酶通过促进血管新生...     

氯沙坦对载脂蛋白E基因缺陷小鼠氧化应激及动脉粥样硬化斑块稳定性的影响

目的观察血管紧张素Ⅱ1型受体拮抗剂氯沙坦对载脂蛋白E基因缺陷小鼠氧化应激及主动脉粥样斑块中血管平滑肌细胞、巨噬细胞数量影响,探讨氯沙坦稳定斑块的作用及可能机制。方法27只8周龄雄性载脂蛋白E基因缺陷小鼠随机等分三组:对照组、氯沙坦低剂量组[5 mg/(kg.d)]及氯沙坦高剂量组[25 mg/(kg.d)],20周后处死动物。常规生物化学法测定血清一氧化氮含量、超氧化物歧化酶活性、丙二醛及血脂水平;采用HE染色法观察小鼠主动脉粥样硬化病变形成;免疫组织化学法分析粥样斑块中血管平滑肌细胞和巨噬细胞数量。结果三组间血脂水平无显著性差异;与对照组相比,氯沙坦低、高剂量组血清一氧化氮水平和超氧化物歧化酶活性均明显升高(P<0.01)、丙二醛水平显著减低(P<0.05和P<0.01),且氯沙坦低剂量和高剂量组间也有明显差异(P<0.01);氯沙坦干预后动脉粥样斑块纤维帽厚,脂质核心小;氯沙坦治疗组斑块中平滑肌细胞数量显著增加(P<0.01)、巨噬细胞数量明显降低(P<0.01),且氯沙坦高剂量组较低剂量组作用更明显(P<0.01)。结论氯沙坦在不影响血脂水平情况下,可通过减轻载脂蛋白E基因缺陷小鼠氧化应激,增加斑块中平滑肌细胞数量,降低巨噬细胞数量,可能起到稳定粥样斑块作用,且随剂量增加作用增强。     

南蛇藤素对载脂蛋白E基因敲除小鼠主动脉壁C反应蛋白及组织因子表达的影响

目的探讨南蛇藤素对高脂饲养载脂蛋白E基因敲除小鼠在动脉粥样硬化病变形成的早期动脉壁内C反应蛋白和组织因子表达的影响。方法8周龄雄性载脂蛋白E基因敲除小鼠12只,随机分为南蛇藤素干预组或二甲基亚砜溶剂对照组,每组各6只。均给予高脂饲养8周,在高脂饲养的后4周,分别给予南蛇藤素2mg/(kg·d)或相当剂量的二甲基亚砜腹腔注射。麻醉处死小鼠后,取小鼠主动脉,以石蜡包埋,行主动脉根部连续切片;以HE染色观察形态学变化,免疫组织化学法检测主动脉壁内C反应蛋白和组织因子的表达水平,以Image Pro Plus6.0软件进行图像分析。结果南蛇藤素干预组主动脉粥样硬化斑块面积明显小于对照组,分别为4947±1277μm2和8403±2535μm2(P<0.05);南蛇藤素组主动脉粥样斑块面积/血管壁面积比值明显小于对照组(P<0.05);南蛇藤素组动脉壁C反应蛋白表达水平较对照组明显减少,平均光密度值分别为0.0152±0.0052与0.0256±0.0026(P<0.05);动脉粥样硬化斑块内组织因子表达水平较对照组明显减少,平均光密度值分别为0.0326±0.0132与0.0763±0.0347(P<0.05)。结论南蛇藤素可能通过抑制载脂蛋白E基因敲除小鼠炎症反应和动脉壁中C反应蛋白的表达而发挥抗动脉粥样的作用;还可能通过减少粥样斑块中组织因子的产生,而进一步起到稳定动脉粥样硬化斑块的作用。     

南蛇藤素对载脂蛋白E基因敲除小鼠斑块内胶原、巨噬细胞移动抑制因子和基质金属蛋白酶9表达的影响

目的观察南蛇藤素对载脂蛋白E基因敲除小鼠斑块中胶原、巨噬细胞移动抑制因子和基质金属蛋白酶9表达的影响。方法8周龄雄性载脂蛋白基因敲除小鼠12只,随机分为南蛇藤素干预组和动脉粥样硬化模型组,每组各6只,同龄的雄性C57BL/6J小鼠6只作为正常对照,各组均给以高脂饮食饲养8周,在高脂饲养的后4周,分别予以南蛇藤素和相当剂量的溶剂二甲基亚砜腹腔注射,每日1次,连续用药4周;处死后行主动脉连续石蜡切片、HE染色观察组织形态学改变,苦味酸-天狼星红染色检测斑块内胶原含量,免疫组织化学方法观察主动脉斑块内巨噬细胞移动抑制因子和基质金属蛋白酶9蛋白表达的强度。结果模型组形成了早期斑块,南蛇藤素组斑块面积较模型组明显减小,分别为4270.74±1027.64μm2和8971.19±1665.76μm2(P<0.01),南蛇藤素组斑块内胶原含量显著高于模型组(平均光密度分别为0.0275±0.0068和0.0142±0.0054,P<0.01);南蛇藤素组与模型组比较斑块内基质金属蛋白酶9表达明显降低(平均光密度分别为0.0054±0.0020和0.0263±0.0080,P<0.001),巨噬细胞移动抑制因子的表达也明显降低(平均光密度分别为0.0114±0.0016和0.0227±0.0039,P<0.001)。结论南蛇藤素可能通过下调载脂蛋白E基因敲除小鼠斑块内基质金属蛋白酶9和巨噬细胞移动抑制因子表达,抑制胶原的降解进而发挥抗动脉粥样硬化及稳定斑块作用。     

糖尿病载脂蛋白E基因缺陷小鼠动脉粥样硬化斑块炎症反应增强

目的观察伴糖尿病的载脂蛋白E基因缺陷雄性小鼠自发性动脉粥样硬化斑块形态和分子生物学特性的变化。方法链脲霉素60mg/(kg·d)腹腔注射诱导载脂蛋白E基因缺陷雄性小鼠糖尿病组,非糖尿病组给予等量缓冲液注射。饲养14周后处死小鼠,分别于建模前和处死前测定小鼠体重、血清总胆固醇、血糖、血清糖基化终产物水平。应用Westernblot检测主动脉环氧化酶2、前列腺素合成酶微粒体亚单位Ⅰ型、基质金属蛋白酶9、糖基化终产物受体表达水平。应用HE、油红O、天狼星红染色分析斑块面积、脂质、胶原含量。应用免疫组织化学检测斑块内巨噬细胞、T细胞、血管平滑肌细胞α肌动蛋白密度,环氧化酶2、前列腺素合成酶微粒体亚单位Ⅰ型、基质金属蛋白酶9、糖基化终产物受体表达水平。结果与非糖尿病组比较,糖尿病组血清总胆固醇明显增高(P<0.01),血清糖基化终产物增高(P<0.05);糖尿病组斑块面积增大,斑块内巨噬细胞密度、环氧化酶2、前列腺素合成酶微粒体亚单位Ⅰ型表达增多(P<0.05),T细胞密度、脂质含量、糖基化终产物受体、基质金属蛋白酶9表达显著升高(P<0.01),胶原含量、血管平滑肌细胞密度显著降低(P<0.01)。结论载脂蛋白E基因缺陷糖尿病小鼠较非糖尿病小鼠动脉粥样硬化更严重,斑块内炎症反应明显增强,这可能是糖尿病动脉粥样硬化斑块不稳定增加的机制之一。     

CCR2受体介导单核细胞趋化蛋白1诱导的人脐静脉内皮细胞凋亡

目的观察载脂蛋白E基因敲除小鼠头臂干动脉粥样硬化斑块在进展过程中斑块内部不同组分的变化情况。方法将18只8周龄载脂蛋白E基因敲除(ApoE-/-)小鼠随机分为三组,每组6只,给与西方膳食饲料分别饲养至24周龄、32周龄和40周龄后,麻醉开胸经下腔静脉取血后采用生物化学方法检测血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)和高密度脂蛋白胆固醇(HDLC);取出头臂干动脉后用4%多聚甲醛固定,常规脱水,石蜡包埋并切片得到....     

载脂蛋白E基因敲除小鼠动脉粥样硬化斑块中血小板因子4和Toll样受体2的表达

目的观察高脂饲养的载脂蛋白E基因敲除小鼠动脉粥样硬化斑块表达Toll样受体2和血小板因子4的情况,探讨血小板因子4对内皮细胞Toll样受体2表达的影响。方法高脂饲料喂养载脂蛋白E基因敲除小鼠12周,建立动脉粥样硬化模型。安乐死处死动物,原位灌流固定,取主动脉于10%中性缓冲福尔马林中固定,石蜡包埋连续切片,HE染色观察动脉粥样硬化斑块形态,免疫组织化学检测斑块中Toll样受体2和血小板因子4的表达。结果载脂蛋白E基因敲除小鼠血脂水平明显增高,主动脉HE染色可见态动脉粥样硬化病变。在载脂蛋白E基因敲除小鼠主动脉富含脂质斑块中Toll样受体2表达上调,其中血管内皮细胞、巨噬细胞表达Toll样受体2明显增多。载脂蛋白E基因敲除小鼠主动脉斑块中也发现有血小板因子4表达,主要在内皮细胞和动脉粥样硬化斑块肩部。结论1.载脂蛋白E基因敲除小鼠粥样斑块中Toll样受体2表达上调,并且Toll样受体2主要表达在粥样斑块的内皮细胞和巨噬细胞上。2.载脂蛋白E基因敲除小鼠动脉粥样硬化斑块中可见血小板因子4表达。     

血脂康对载脂蛋白E基因敲除小鼠肝细胞内Ca2+及线粒体膜电位的影响

目的观察血脂康胶囊对载脂蛋白E基因敲除小鼠肝细胞内Ca2 浓度及线粒体膜电位的影响。方法采用胶原酶消化法分离载脂蛋白E基因敲除小鼠肝细胞,体外原代培养8天后,加入含10%血脂康血清的培养基,48 h后以Flou-3/AM和JC-1为探针,应用激光共聚焦显微镜测量肝细胞内Ca2 浓度和线粒体膜电位。结果血脂康可明显降低载脂蛋白E基因敲除小鼠肝细胞内Ca2 浓度,与对照组比较差异有显著性(P<0.01);同时,血脂康可明显提高载脂蛋白E基因敲除小鼠肝细胞线粒体膜电位(P<0.05)。结论血脂康可降低载脂蛋白E基因敲除小鼠肝细胞内Ca2 浓度,提高线粒体膜电位,这可能是血脂康对抗高脂血症发生和发展的重要机制之一。     

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.     

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.     

N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis： Randomized,placebo-controlled pilot study

AIM： To evaluate the effectiveness and safety of oral N-acetyl-L-cysteine （NAC） co-administration with mesalamine in ulcerative colitis （UC） patients.
METHODS： Thirty seven patients with mild to moderate UC were randomized to receive a four-wk course of oral mesalamine （2.4 g/d） plus N-acetyl-L-cysteine （0.8 g/d） （group A） or mesalamine plus placebo （group B）. Patients were monitored using the Modified Truelove-Witts Severity Index （MTWSI）. The primary endpoint was clinical remission （MTWSI ≤ 2） at 4 wk. Secondary endpoints were clinical response （defined as a reduction from baseline in the MTWSI of ≥ 2 points） and drug safety. The serum TNF-α, interleukin-6, interleukin-8 and MCP-1 were evaluated at baseline and at 4 wk of treatment. RESULTS： Analysis per-protocol criteria showed clinical remission rates of 63% and 50% after 4 wk treatment with mesalamine plus N-acetyl-L-cysteine （group A） and mesalamine plus placebo （group B） respectively （OR = 1.71; 95% CI： 0.46 to 6.36; P = 0.19; NNT = 7.7）. Analysis of variance （ANOVA） of data indicated a significant reduction of MTWSI in group A （P = 0.046） with respect to basal condition without significant changes in the group B （P = 0.735） during treatment. Clinical responses were 66% （group A） vs 44% （group B） after 4 wk of treatment （OR = 2.5; 95% CI： 0.64 to 9.65; P = 0.11; NNT = 4.5）. Clinical improvement in group A correlated with a decrease of IL-8 and MCP-1. Rates of adverse events did not differ significantly between both groups.
CONCLUSION： In group A （oral NAC combined with mesalamine） contrarily to group B （mesalamine alone）, the clinical improvement correlates with a decrease of chemokines such as MCP-1 and IL-8. NAC addition not produced any side effects.     

Delorme's transrectal excision for internal rectal prolapse

Surgical therapy of functional outlet obstruction in patients with internal rectal intussusception may include abdominal, perineal, or transrectal procedures. Because abdominal procedures often result in significant physiologic impact but unrelieved constipation, the authors have elected Delorme's transrectal excision for management of these patients. Since a short-term placebo effect attends many therapies, this report describes results of transrectal excision only after a threeyear postoperative period. Delorme's transrectal excision of internal intussusception accomplished sustained symptomatic relief in over 70 percent of otherwise refractory constipated patients. The association of internal intussusception with other abnormalities underscores the importance of defining both anatomic and functional components when selecting patients whose constipation may require surgical therapy. Critical technical elements, surgical pitfalls, and potential complications of the procedure are discussed.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Toronto, Canada, June 11 to 16, 1989.     

The oral glucose tolerance test: A comparison of the time points on the basis of limit values,normal dispersion,and reproducibility

Summary Time points in the glucose tolerance test (GTT) are compared on the basis of limit values, dispersion within a reference population, and reproducibility. We suggest using the distance between a limit value and the median reference value as a measure of the magnitude of abnormality. The distance between 140 mg/100 ml and the median fasting plasma glucose value is chosen as a standard distance and limits for other points in the GTT are calculated to equal this standard distance of abnormality. We suggest that the probability of correctly interpreting an inividual result is directly related to the reproducibility of the test and inversely related to the percentage of the total range of values which is dispersed among the normal population. The ratio of reproducibility to percentage normal dispersion is proposed as an index of the probability of correctly interpreting an individual result. According to this index, the probability of correct interpretation varies in order: fasting plasma glucose concentration>3-h>2-h>0.5-h>1-h plasma glucose concentration.