IL-1β诱导软骨细胞培养金属蛋白酶/金属蛋白酶抑制剂水平及药物对其影响

目的　探讨体外培养的原代软骨细胞及加入白细胞介素 (IL) 1β诱导软骨细胞中金属蛋白酶 /金属蛋白酶抑制剂水平变化及四环素、强力霉素及中药骨碎补对其影响。方法　采用体外培养的兔软骨原代细胞为模型 ,分别加入含有 10 %四环素、强力霉素及骨碎补含药血清 ,实验组加入10ng/mlIL 1β ,诱导软骨细胞变性 ,均培养 4 8h分离上清液 ,采用酶联免疫方法测定各组培养液中基质金属蛋白酶 3(MMP 3)及金属蛋白酶组织抑制剂 1(TIMP 1)含量。结果　经 10ng/mlIL 1β诱导后 ,软骨细胞MMP 3/TIMP 1水平显著性升高 (P <0 0 1) ;对于加入IL 1β诱导的软骨细胞 ,与空白血清对照组比较 ,含骨碎补药物血清和含强力霉素药物血清均降低软骨细胞MMP 3/TIMP 1水平 ,且强力霉素含药血清组与空白对照组比较差异具有显著性 (P <0 0 1) ,而含四环素药物血清则升高软骨细胞MMP 3/TIMP 1水平 ,但与空白对照组比较差异无显著性 (P >0 0 5 ) ;对于不加IL 1β诱导的软骨细胞来说 ,3种含药血清均可升高软骨细胞MMP 3/TIMP 1水平 ,且含骨碎补药物血清和含四环素药物血清与空白对照组比较差异均有显著性 (P <0 0 1)。结论　IL 1β可上调体外培养的原代软骨细胞MMP 3/TIMP 1水平 ,强力霉素和骨碎补可以下调经IL 1β诱导的软骨细胞MM     

雌二醇对肾小管上皮细胞hUAT基因及蛋白表达的影响

目的观察不同浓度雌二醇对肾小管上皮细胞（HK-2细胞）人尿酸盐转运子（hUAT）基因表达的影响。方法取18瓶HK-2细胞,随机分为对照组、E1、E2组,每组6瓶。对照组培养液为DMEM＋0.5%乙醇,E1组为DMEM＋10^-8mol/L雌二醇＋0.5%乙醇,E2组为DMEM＋10^-6mol/L雌二醇＋0.5%乙醇。均培养48 h。采用实时荧光定量PCR及Western blot法分别检测三组细胞中hUAT mRNA及蛋白的相对表达量。结果所有标本均能检测到hUAT mRNA和蛋白的表达。E1组hUAT mRNA表达水平为对照组的167%,E2组hUAT mRNA表达水平为对照组的187%。蛋白表达与mRNA表达结果一致。结论雌二醇可上调hUAT mRNA及蛋白的表达。     

17β-雌二醇对新生大鼠成骨细胞护骨素和破骨细胞分化因子表达的调节

体外培养成骨细胞，用不同浓度（10^-11～10^-6mol／L）17β-雌二醇干预，RT—PCR测定护骨素、破骨细胞分化因子（ODF）mRNA的表达水平。雌二醇作用后，成骨细胞护骨素表达上调（P〈0．05），以10^-8mol／L最显著；ODF表达无明显变化。雌激素治疗骨质疏松症的作用可能与其在生理浓度时促进成骨细胞护骨素表达有关。     

罗格列酮对高糖环境下大鼠肾脏成纤维细胞MMP-1 TIMP-1及Ⅲ型胶原mRNA表达的影响

目的 观察罗格列酮（RGZ）对高糖环境下大鼠肾脏成纤维细胞（NRK）基质金属蛋白酶-1（MMP—1）、基质金属蛋白酶抑制剂-1（TIMP—1）及Ⅲ型胶原（COLⅢ）基因表达的影响，探讨罗格列酮对糖尿病肾病的保护作用及其机制。方法 2005年1月至2005年9月对郑州大学第一附属医院的体外培养NRK细胞，分成正常对照组（NG含1000mg／LD-葡萄糖）、高糖组（HG含4500mg／LD-葡萄糖）、HG＋RGZ组（5μmol／L）、HG＋RGZ组（10μmol／L）和HG＋RGZ组（15μmol／L），作用24h后，用逆转录-聚合酶链反应（RT—PCR）的方法检测MMP—1、TIMP—1和collagen Ⅲ mRNA表达。结果 HG组细胞MMP—1mRNA水平较NG组下降，差异有显著性（P〈0.01），罗格列酮可以一定程度上恢复MMP—1的表达。HG组TIMP—1和COL ⅢmRNA水平较NG组升高，差异有显著性（P〈0．01），罗格列酮可以剂量依赖性抑制这种高表达。结论 罗格列酮可以通过调节MMP—1和TIMP—1的基因表达，抑制高糖导致的肾脏成纤维细胞外基质的蓄积。     

ERK1/2蛋白在17β-雌二醇抑制睾酮诱导的心肌细胞肥大反应中的作用

目的 观察17β-雌二醇对睾酮诱导的心肌肥大反应的影响,探讨细胞外信号调节激酶(ERK1/2蛋白)在性激素对心肌肥大影响中的作用.方法 采用差速贴壁法分离、纯化培养新生SD大鼠心肌细胞,以Bradford法测定心肌细胞蛋白质含量,同位素法分析3H-亮氨酸(3H-Leu)掺入,以免疫印迹法检测心肌细胞ERK1/2蛋白表达水平的变化.结果 10-10 ～ 10-6 mol/L 17β-雌二醇可明显对抗睾酮诱导的心肌细胞蛋白质含量和3H-Leu掺入的增加,其中以10-8 mol/L 17β-雌二醇作用最为明显；预先给予10-6 mol/L雌激素受体拮抗剂他莫昔芬作用2h,可部分取消17β-雌二醇对睾酮诱导的心肌细胞蛋白质含量增加的抑制效应.用50μmol/L ERK1/2上游激酶MEK1/2的特异性抑制剂PD98059预处理2h不能增强17β-雌二醇对睾酮诱导的心肌细胞3H-Leu掺入的抑制作用；10-8 mol/L 17β-雌二醇可以对抗睾酮诱导的心肌细胞ERK1/2蛋白表达增加；10-6mol/L他莫昔芬预处理2 h可部分取消17β-雌二醇对睾酮诱导的心肌细胞ERK1/2蛋白表达增加的抑制作用.结论 17β-雌二醇经雌激素受体介导下调睾酮诱导的心肌细胞ERK1/2蛋白表达,从而抑制由睾酮诱导的心肌细胞肥大反应.     

核因子—kB反义寡核苷酸对系膜细胞炎症因子基因表达的影响

目的：探讨NF－kB反义寡核苷酸（oligodeoxynucleotide,ODN)对人肾小球系膜细胞炎症因子表达的影响，为利用NF－kB反义ODN治疗肾小球炎性病变奠定基础。方法：人工合成p65反义、正义及错配ODN并行全程硫代磷酸化修饰。应用核酸酶保护法观察阳离子脂质体介导的不同浓度的ODN（0．001、0．01、0．1、1、10μmol/L)对系膜细胞TNF－α、IL－1α、IL－1β、MCP－1、IL－8、TGF－β1 mRNA表达的影响，以正义ODN（10μmol/L)及错配ODN（10μmol/L)作为对照组。结果：正常培养状态下，系膜细胞可组成型表达TNF－α、IL－1β、IL－8和TGF－β1 mRNA，而不表达IL－1α和MCP－1 mRNA。细菌脂多糖（lipopolysaccharide,LPS)刺激后上述6种炎症因子表达显著上调。p65反义ODN可呈剂量依赖性地抑制LPS诱导的系膜细胞炎性细胞因子TNF－α，IL－α，IL－1β，MCP－1和IL－8的基因表达，而对TGF－β1无显著抑制作用；p65正义及错配ODN均不能抑制炎性细胞因子的表达。结论：p65反义ODN可明显抑制LPS诱导的肾小球系膜细胞炎性细胞因子的表达，提示NF－kB在肾小球疾病进展中起关键性调控作用，其反义ODN有可能应用于肾脏病变的实验性治疗之中。     

脱氢表雄酮改变血管张力的作用机制

目的 探讨脱氢表雄酮（DHEA）改变血管张力的机制。方法 采用RT-PCR及Western Blot技术测定DHEA作用下血管紧张素Ⅱ类亚型Ⅰ类受体（AT1）的变化。结果 ①在10^1-mol/L-10^-6mol/L DHEA作用下，mRNA表达分别降低了36.5%、36.8%、49.5%，其后从中选出10^-8mol/L DHEA组加入Tamoxifen,mRNA表达较10^-8mol/L DHEA组增加，10^-4mol/L DHEA加入Flutamide则有所降低，但无统计学意义。②相比之下，在10^-10mol/L-10^-6mol/L DHEA作用下，AT1的蛋白表达依次降低了62.5%、72.3%、85.2%，从中选中10^-8mol/L组分别加入Tamoxifen及Flutamide，其蛋白表达较10^-8mol/L组增加且有显著差异。结论 DHEA通过雌、雄激素受体抑制AT1的作用，从而改变血管张力。     

雌三醇对MG-63细胞增殖和分化的影响

目的 研究雌三醇（Estri01）对成骨肉瘤样细胞株MG-63的作用，并与雌二醇（17-β—estradiol）对MC-63细胞的作用进行比较，从而探讨雌三醇防治骨质疏松的作用机制。方法 用雌三醇或雌二醇处理成骨样细胞株MC-63，^3H掺入法（3H—TdR）测定细胞的增殖，通过测定细胞内碱性磷酸酶（ALP）活性的变化和细胞分泌的骨钙素（osteocalcin）水平的变化来分析细胞功能。结果 以浓度为0mol／L的雌三醇为对照，10^-10、10、10^～8、10^-7、10^-6mol／L雌三醇分别增加MG-63细胞增殖达0．00％、18．10％、31．62％、23．81％、14．86％；以浓度为0mol／L的雌二醇为对照，10^-10、10^-9、10^-8、10^-7、10^-8mol／L雌二醇分别增加MG-63细胞增殖达16．95％、30．86％、62．48％、28．19％、24．76％。雌二醇促进MC-63细胞增殖的作用比雌三醇的作用强。不同浓度（10^-10～10^-6mol／L）的雌三醇或雌二醇对MG-63细胞内ALP活性及骨钙素分泌量均无显著影响。Western杂交法检测到雌激素受体α和β在MG-63细胞中均有表达，雌激素受体的拮抗剂ICI 182780可以消除雌二醇和雌三醇对MG-63细胞增殖的促进作用。结论雌三醇可以促进MG-63细胞的增殖，但对分化无影响；雌三醇对MG-63细胞增殖的促进作用由雌激素受体介导。     

重型肝炎患者肝组织基质金属蛋白酶-1及其抑制因子-1 mRNA的表达

目的：观察重型肝炎患者基质金属蛋白酶－1（MMP－1）和金属蛋白酶组织抑制因子－1（TIMP－1）mRNA的表达以及胶原蛋白的沉积情况，从胶原降解的角度探讨重型肝炎致肝纤维化的机制。方法：重型肝炎肝组织标本20例，非肝病患者肝组织6例，用原位杂交法检测肝组织MMP－1和TIMP－1 mRNA-1 的表达，并作I、Ⅳ型胶原的免疫组化以及天狼红胶原染色。结果：与对照组比较，重型肝炎组的MMP－1 mRNA和TIMP－1 mRNA表达显著增加，肝组织胶原蛋白总含量和I、Ⅳ型胶原蛋白含量亦显著增加。肝组织胶原蛋白总含量和I、Ⅳ型胶原蛋白含量与MMP－1 mRNA表达无明显相关性，与TIMP－1 mRNA表达呈正相关。结论：重型肝炎患者肝纤维化的发生与金属蛋白酶抑制因子增加、抑制金属蛋白酶的活性、降低间质胶原蛋白的分解有关。     

复元胶囊对实验性骨关节炎软骨中MMP13、TIMP1及TIMP2的影响

目的观察复元胶囊对实验性骨关节炎软骨中基质金属蛋白酶13、组织型金属蛋白酶抑制剂1,2及病理形态方面的影响。方法选用新西兰兔66只,随机分为:正常对照组6只,不给予任何处理;模型对照组12只,造模后生理盐水灌胃;四环素组、复元胶囊低、中、高剂量组各12只,造模后分别用四环素、复元胶囊灌胃。连续灌胃4~12w后,比较各组关节软骨病理变化;免疫组化法检测兔膝关节软骨中MMP13、TIMP2蛋白质水平的变化;RT-PCR法检测关节软骨中MMP13、TIMP1及TIMP2mRNA表达。结果实验组软骨Mankin′s评分都显著低于模型对照组,实验组MMP13的mRNA表达水平明显低于模型对照组,而其TIMP1、TIMP2的mRNA的水平较模型对照组有所增加。MMP13主要表达于软骨表层及中上层,实验组MMP13表达量低于模型对照组(P<0.05)。结论复元胶囊能明显抑制骨关节炎软骨中MMP13的蛋白和mRNA的水平,能提高OA软骨中TIMP1,2的蛋白和mRNA的水平,稳定二者水平,对软骨退变有一定的防治作用。     

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.     

治疗高血压药物的经济学评价

重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。