慢性低氧大鼠肾上腺皮质球状带的变化

将Ｗｉｓｔａｒ大鼠喂养在逐渐降低的常压低氧条件下，用氮气和空气的混合气体调节氧含量。氧浓度由正常逐步降低为１５％、１２％、１０％、８％，最后降至７％，实验共进行１１２ｄ，结果显示低氧动物体重下降，肾上腺重量减少，肾上腺皮质球状带萎缩，脂质丢失，球状带细胞线粒体肿胀和空泡变性，溶酶体增多，表明在慢性常压低氧中，当吸入气氧含量降至７％时，可导致肾上腺皮质球状带细胞超微结构改变，从而影响醛固酮的合成与分     

苯二氮受体的分型

利眠宁、安定等苯二氮草(BDZ)类药物是临床上广泛使用的药物。自从1977年BDZ受体的概念提出来后,BDZ受体的研究进展甚快。与其它受体的研究一样,随着研究的发展,也产生了受体分型的问题。本文主要介绍BDZ受体的分型。与胆碱能受体,肾上腺素能受体等比较,BDZ受体的分型还不够成熟,从现有的资料来看,有三种主要的分型方法:1.“中枢型”和“外周型”;2.nM高亲和力型和uM低亲和力型;3.BDZ1和BDZ2型。     

实验性糖尿病大鼠肾上腺皮质球状带,甲状腺和垂体的病理形态学观察

为探讨实验性糖尿病大鼠肾上腺皮质球状带及甲状腺的病理形态改变。通过光镜、电镜定性观察及形态计量研究，发现肾上腺皮质球状带实质细胞及甲状腺滤泡上皮细胞有萎缩，细胞器发生退行性变。而垂体促甲状腺激素（ＴＳＨ）分泌细胞的细胞器无器质性改变，但分泌功能受损。说明糖尿病时肾上腺皮质球状带及甲状腺功能低下与该疾病对二者产生的形态学改变有关，而垂体分泌ＴＳＨ能受损也可能为造成甲状腺功能低下的原因之一。     

肾透明细胞癌伴同侧肾上腺皮质腺瘤内转移1例及文献复习

目的：探讨1例肾透明细胞癌(clear-cell renal cell carcinoma,clear-cell RCC)伴同侧肾上腺皮质腺瘤内转移的临床病理特征及转移机制。方法：观察1例肾透明细胞癌转移至同侧肾上腺皮质腺瘤的临床表现、组织学特征、免疫组织化学特点,并复习相关文献。结果：患者,男性,63岁,右季肋部不适半月余入院。术后结果显示右肾透明细胞癌。单纯性孤立性肾囊肿。右肾上腺皮质腺瘤,瘤内见转移的肾透明细胞癌、直径约3 mm。结论：肾透明细胞癌转移至同侧肾上腺皮质腺瘤是非常罕见的现象。     

苯二氮类药物对细胞免疫功能的影响

苯二氮类药物（安定）能促进小鼠胸腺细胞增殖,这种作用以安定5mg/kg腹腔注射,每天一次连续给药5d的作用最强。安定对小鼠脾脏细胞增殖、自然杀伤（NK）细胞毒活性、脾细胞初次抗体产生以及对体外培养胸腺细胞增殖等均无明显影响。安定对截肢应激所致小鼠胸腺、脾脏细胞免疫抑制有拮抗作用,并可有效地拮抗应激导致的小鼠胸腺重量减轻。     

肾淋巴管结扎对单肾切除大鼠的肾损害作用

目的： 探讨肾淋巴循环障碍及单侧肾脏切除对大鼠肾脏功能结构的损害。方法： 雄性Wistar大鼠,随机分为3组：双肾淋巴管结扎组（2KL）,左肾淋巴管结扎伴右肾切除组（1KL）,假手术组（sham）。分别在术后1、2、4、8周每组各处死6只。测定24 h尿蛋白和血尿肌酐。用PAS和Masson染色观察肾组织病理改变。用RT-PCR检测TGF-β1、Smad2/3、I型胶原（col I）mRNA的表达量;用免疫组化和Western blotting方法检测组织col I、TGF-β1、Smad2/3和磷酸化Smad2/3（p-Smad2/3）的蛋白表达量及主要表达部位。结果： 2KL和 1KL大鼠出现明显的蛋白尿和肾功能衰竭,1KL大鼠的肾脏损害尤其明显,随着时间推移逐渐加重,并出现明显的组织病理改变。2KL和 1KL大鼠肾组织中col I、TGF-β1、Smad2/3、p-Smad2/3的蛋白和（或）基因表达水平也明显增高（P<0.01）,且主要表达在肾小管上皮细胞及肾间质。1KL大鼠的表达也明显高于2KL大鼠。结论： 肾淋巴循环障碍可导致大鼠肾脏功能及小管间质的损害,并随时间而加重。当淋巴循环障碍伴对侧肾切除时,损害明显加重。     

大鼠残肾细胞凋亡及凋亡相关基因的动态表达及意义

目的： 研究在5/6肾切除大鼠不同时段残肾组织中肾实质细胞凋亡及相关基因Bax、Bcl-2、caspase-3、caspase-8、caspase-9 mRNA、蛋白质的动态表达变化及其意义。 方法: SD大鼠5/6肾切除后,分别在1周、2周、4周、8周、12周、16周、26周、40周采集标本，普通光镜、电镜观察残肾病理改变、TUNEL法检测肾脏细胞凋亡、RT-PCR和Western blotting检测残肾组织凋亡相关基因mRNA和蛋白质的变化、免疫组织化学进行蛋白质定位，分析凋亡、增殖与肾小球硬化和间质纤维化的相关关系。 结果: 5/6肾切除后大鼠残肾出现进行性肾小球硬化及间质纤维化病变。肾增殖与凋亡水平高于对照组，肾实质凋亡细胞以肾小管上皮细胞和肾间质细胞为主。肾小球凋亡指数与肾间质炎细胞浸润和24 h尿蛋白呈显著正相关(r=0.788、r=0.822,P<0.01);肾小管凋亡指数与血肌酐、尿素氮、24 h尿蛋白、炎细胞浸润指数呈显著正相关（r=0.824、0.794、0.883、0.948，P<0.01）。促凋亡相关基因Bax、caspase-3、caspase-8、caspase-9mRNA及相应蛋白质明显增加且表达一致，在病变过程中呈波浪式上调，高峰分别在4周和40周，这些变化与肾间质炎细胞浸润指数的变化呈显著正相关（P<0.01）；抑制凋亡因子Bcl-2表达与对照组比较无明显差异。 结论: 细胞凋亡参与肾小球硬化、肾小管萎缩及间质纤维化的过程，肾间质炎细胞的浸润更促进残肾凋亡的发生。     

后腹腔镜下肾切除术中肾血管的处理方法探讨

目的 探讨后腹腔镜下肾切除术中左右肾血管不同的处理方法及临床价值.方法 回顾性分析2005年3月至2011年12月行后腹腔镜下肾切除术的64例患者的病例资料及手术视频,总结术中处理肾血管的经验.术中以腰肌前间隙内侧弓状韧带为解剖标志寻找右肾蒂,小心处理右肾静脉防止撕裂下腔静脉;在腰肌前间隙腹主动脉旁脂肪前内寻找左肾蒂,避免损伤或漏扎左肾血管属支.结果 64例手术均获成功,无中转开放手术及输血病例,术后未出现严重并发症.结论 熟悉肾血管的解剖特征,采用不同的方法分别处理左右肾血管,有利于提高后腹腔镜下肾切除术的安全性.     

后腹腔镜与传统开放根治性肾切除术治疗肾细胞癌护理对比分析

目的探讨后腹腔镜与传统开放根治性肾切除术治疗肾细胞癌的护理方法的差异,从而提高肾细胞癌患者的护理质量和工作效率。方法回顾性分析我院2007年1月~2013年6月37例肾癌患者临床资料,通过对后腹腔镜组与传统开放手术组的心理护理、术前指导和术后的常规护理、术后离床活动时间、肠道恢复时间、平均住院天数、切口疼痛、并发症等资料进行对比分析。结果后腹腔镜与传统开放根治性肾切除术治疗肾细胞癌在术后离床活动时间、肠道恢复时间、平均住院天数、切口疼痛、并发症等方面有统计学意义,优势明显。结论经后腹腔镜肾癌根治术治疗肾癌与开放手术相比较具有微创、痛苦小、恢复快等优点。     

中药脊髓Ⅰ号对脊髓损伤后大鼠肾上腺皮质酶组织化学的影响

目的： 探讨脊髓损伤后服用中药脊髓Ⅰ号（SC-I）对脊髓损伤后大鼠肾上腺皮质细胞琥珀酸脱氢酶（SDH）和3β-羟基类固醇脱氢酶（3β-HSD）的影响。 方法： 用组织化学方法和图像分析技术观察Wistar大鼠下胸髓半横断损伤后服用SC-I而引起的肾上腺皮质细胞SDH 和3β-HSD的变化。 结果： 脊髓半横断损伤后1d组大鼠肾上腺皮质束状带和网状带细胞SDH和3β-HSD活性均显著强于正常对照组（P<0.01）；损伤后3 d组SDH和3β-HSD活性与1 d组无明显差异（P>0.05）；损伤后服用SC-I 冲剂3 d组SDH和3β-HSD活性明显弱于损伤后1 d组（P<0.05），但与正常对照组无显著差异。 结论： 脊髓损伤后大鼠肾上腺皮质分泌激素的功能增强；服用SC-I后肾上腺皮质功能逐渐正常化。     

Angiotensin-mediated calcium efflux from adrenal glomerulosa cells

The effects of angiotensin II on efflux of radiocalcium and production of aldosterone from dispersed bovine adrenal glomerulosa cells were studied using a flow-through system. Concentrations of angiotensin II between 1.25 X 10(-10) and 1.25 X 10(-8) M were found to stimulate both radiocalcium efflux and the rate of aldosterone production. The increase in radiocalcium efflux occurred within 1.5-2.5 min after angiotensin addition, reached a peak in 3.0-4.5 min, and then declined to a value slightly greater than control. The initial increase in aldosterone production occurred 3-5 min after the peak of calcium efflux. In cells preloaded with [45Ca] and then perfused for 1 h with a medium containing no calcium, the basal rate of aldosterone production fell to zero. Angiotensin II (1.25 X 10(-8) M) caused no increase in aldosterone secretion rate but still caused an efflux of radiocalcium. Exposure of cells to 5 X 10(-5) M verapamil blocked the effect of 1.25 X 10(-10) M angiotensin on both radiocalcium efflux and aldosterone production, but only partially blocked the effects of 1.25 X 10(-8) M angiotensin. In addition to stimulating calcium uptake into adrenal glomerulosa cells, angiotensin II stimulates the mobilization of calcium from an intracellular pool. The precise location of this pool is not known.     

Assessment of malignancy in adrenal cortical tumors

The roles of the pathologist in assessing adrenal cortical tumors are, first, to differentiate adenoma from carcinoma, and, second, to assess prognosis when the diagnosis of malignancy is made. How easy is it to achieve these goals with standard histology and immunohistochemistry, and to what extent can molecular analysis help?     

Differential occurrence and distribution of galanin in adrenal nerve fibres and medullary cells in rodent and avian species

The presence and distribution of galanin (GAL) in adrenal glands of rodent and avian species was investigated by light microscopic immunohistochemistry. GAL immunoreactivity was found in all medullary cells of guinea pig, duck and chicken adrenals. In contrast, only a subpopulation of medullary cells stained for GAL in Phodopus (Djungarian hamster) while the neuropeptide was completely missing in chromaffin cells of rat and pigeon. In rat, guinea pig and pigeon, GAL-immunoreactive nerve fibres were frequent in subcapsular regions and sparse in deeper cortical layers and in the chromaffin tissue. In contrast, only very few GAL fibres were found in Phodopus and no GAL fibres were observed in the adrenal glands of duck. In the chicken adrenal gland, fibres containing GAL were numerous throughout the organ and occurred in close vicinity to both steroidogenic as well as catecholaminogenic cells. The striking differences in the presence of GAL-positive cells and fibres are more pronounced between species within the rodent or avian group, respectively, than between the different vertebrate orders. The hitherto unknown and surprising variability of GAL expression and distribution in adrenal glands of various species suggests species-dependent functional (autocrine, paracrine and/or endocrine) roles of GAL in the neuroadrenal axis.     

γ－干扰素样物质在肾上腺皮质腺肿瘤中的表达

为了检测γ－干扰素（ＩＦＮ－γ）是否在人肾上腺组织和肾上腺皮质腺肿瘤中有表达，我们对包括瘤旁肾上腺组织１４例；肾上腺皮质腺瘤１７例；皮质腺癌７例的组织标本，用抗大鼠ＩＦＮ－γ单克隆抗体ＤＢ－１做为一抗，采用ＡＢＣ法做免疫组化染色。结果：ＩＦＮ－γ样免疫反应阳性物可在１００％（７／７例）肾上腺皮质腺癌，４７％（８／１７例）皮质腺瘤细胞内和３０％腺癌（２／７例）和腺瘤（５／１７例）组织内毛细血管内皮细胞中检出，瘤旁肾上腺组织内未见阳性反应细胞。结论：（１）ＩＦＮ－γ的存在与肾上腺皮质肿瘤的分化有关，分化越低，ＩＦＮ－γ的阳性率越高。（２）肾上腺皮质肿瘤内的毛细血管内皮细胞可能具有ＩＦＮ－γ受体或能产生ＩＦＮ－γ。另外，在肿瘤组织内还发现一些树突状ＩＦＮ－γ阳性细胞，其存在意义尚待探讨。     

Innervation of human adrenal gland and adrenal cortical lesions

The innervation of the human adrenal gland and of cortical lesions was studied in sections of cortical tissue (n=10), hyperplastic cortical tissue (n=3), and tissue from cortical adenomas (n=5) and carcinomas (n=6). The presence and distribution of nerve structures containing neuronal markers indicating sympathetic and parasympathetic innervation were studied by immunohistochemistry and the co-existence and co-localization patterns of the different markers by immunofluorescence. The cortex and hyperplastic cortical tissue had a moderate to rich supply of nerve structures containing the typical neuronal markers: protein gene product 9.5 (PGP 9.5), neuron-specific enolase (NSE), small vesicle synaptic protein type 2 (SV2), and nerves showing immunoreactivity to the adrenergic marker tyrosine hydroxylase (TH). All these immunoreactive nerves were located predominantly adjacent to blood vessels, but also among parenchymal cells. The cortex showed numerous nerve structures containing the neuropeptide substance P (SP), neuropeptide Y (NPY) and vasoactive intestinal protein (VIP), but few nerves containing these peptides were seen in hyperplastic cortical tissue. Typical markers were occasionally observed in cortical adenomas but were not found in carcinomas, except in a few cases where PGP 9.5 and NSE were present, but only adjacent to necrotic areas. Nerves containing NPY and VIP occurred in varying numbers in both adenomas and carcinomas. NPY- and VIP-immunoreactive nerve structures were seen mostly alongside blood vessels. There were several types of co-existence. For instance, NSE/VIP-, TH/VIP- and TH/NPY-immunoreactive nerve structures were often seen in the same trunk, but were only partly co-localized. Received: 19 January 1999 / Accepted: 18 May 1999     

Melatonin and the adrenal cortex: relationship to territorial aggression in mice

The behaviour of male TO mice on confrontation after a period of group housing (3 mice/group) was recorded, both in terms of group and individual aggression measures. A series of treatments was carried out aimed at identifying the relative contributions of corticosteroids (CS) and melatonin (MEL) to control of fighting. Adrenalectomy (ADX) and aminoglutethimide injections (AMG) were used to reduce CS both chronically and acutely, and repeated restraint stress (RES) to increase CS levels chronically. MEL was administered daily (5 days), alone or in combination with other treatments. Control group treatments included sham operation for ADX (SO), and the appropriate saline injections. Untreated groups were also tested. AMG and ADX reduced aggression to a similar extent on all measures. MEL potentiated fighting, but this effect was reversed when given in combination with ADX or AMG. RES was associated with a significant shift towards submission on individual measures, but no significant change in group measures. RES+MEL treatment did not cause any significant changes. SO animals behaved normally, but again, the aggressogenic MEL effect was not seen after SO + MEL. The results are interpreted in terms of partial inhibition of CS output by MEL.     

Diagnostic and molecular aspects of adrenal cortical tumors

Adrenal cortical diseases are relatively rare but tumors are the most common in diagnostic practice. This is reflected by the content of this review. By studying familial syndromes in which they occur more frequently and the pathways involved in steroidogenesis and cortical growth, the molecular genetics of these tumors is being unraveled. Genome-wide approaches have also been helpful. The emerging data may complement standard histological investigation in diagnosis and prognosis.     

四氢生物喋呤对肾切除5／6大鼠高血压和尿蛋白的治疗作用

目的：探讨四氢生物喋呤（BH4）对肾切除5／6（NX）后大鼠血压和尿蛋白的影响。方法38只大鼠按照处理方法的不同分为五组：NX组、NX＋BH4组（腹腔注射）、NX＋L-精氨酸（LA）组、NX＋口服地尔硫卓（DILT）组和假手术组。手术24小时后开始给药，并分别在给药前和给药后的第4周和第8周测量收缩压、测定尿蛋白和肌酐清除率。在实验的第8周末观察肾脏的组织学改变。结果：与假手术组比较，NX大鼠收缩压和尿蛋白均明显升高（P〈O．01）；BH4、LA及DILT对NX所产生的高血压均有降低作用（P〈O．01）；BH4、LA和DILT均使N-X的尿蛋白明显减少（P〈0．01），但DILT的减少幅度相对较小；NX各组，血尿素和血清肌酐都升高，血浆肌酐清除率都降低，各组之间无明显差别（P〉0．05）。NX后的大鼠出现肾小球系膜扩张，而各治疗组肾小球系膜扩张的程度较轻。结论：NX大鼠，手术24小时后补充BH4，在8周的观察期内可以使血压保持正常，并有减少尿蛋白、阻止肾小球系膜扩张的作用。     

Primary aldosteronism with bilateral adrenal adenomas

Summary An unusual case of primary aldosteronism with bilateral single adenomas is reported. The two tumors were revealed by computerized axial tomography and subsequently confirmed by surgical exploration. Spironolactone therapy prior to the operation induced the formation of spironolactone bodies in only one of the two adenomas. As it has been postulated that these cytoplasmic inclusions may reflect the activity of the adenomatous cells, the presence of the bodies in a single adenoma would indicate a unilateral source of the hyperaldosteronism. Thus, the existence of spironolactone bodies could corroborate the data of functional localizing tests more closely than the morphological findings of computerized tomography.     

Changes of plasma and adrenal catecholamines and corticosterone in stressed rats with septal lesions

The effect of septal lesions on plasma catecholamine and corticosterone (B) levels has been studied in rats during single and 7 times repeated immobilization stress (IMO). Blood samples were obtained via a catheter in the tail artery or by decapitation. The increased circulating epinephrine (EPI) and norepinephrine (NE) levels observed in the initial phase of acute stress as well as the elevated baseline EPI level after six times repeated IMO are indicative of an enhanced response of the sympathetic adrenomedullary system after lesions of the septum. After decapitation of rats with septal lesions there was a significant increase in plasma NE one day after the sixth IMO and a block of EPI increase after the seventh IMO compared to sham-operated rats. The adrenocortical system was similarly found to be activated after septal lesions, exhibiting increased baseline plasma B levels. It has been suggested that the septal region affects the studied systems by exerting an inhibitory tonus. The removal of this inhibitory system results in an increase of adrenocortical and sympathetic-adrenomedullary activities.