前列腺素E1对日本血吸虫病大鼠肝纤维化形成的影响

目的探讨前列腺素E1(PGE1)对日本血吸虫病肝纤维化形成的影响及其机制.方法用免疫组化SABC技术结合计算机彩色病理图文分析系统,定量检测并分析PGE1治疗前后,感染日本血吸虫大鼠肝内I、Ⅲ型胶原及转化生长因子β1(TGF-β1)的变化.结果(1)感染组大鼠肝内I、Ⅲ型胶原及TGF-β1均主要分布在虫卵肉芽肿内,呈密集片状着色.经PGE1治疗后I、Ⅲ型胶原及TGF-β1的着色均明显减少.(2)PGE1治疗组I、Ⅲ型胶原及TGF-β1的含量分别为0.2571Sv±0.1939、0.2459Sv±0.1836和0.1351Sv±0.0941(Sv为面密度)均显著低于感染对照组的0.4759Sv±0.2401、0.4612Sv±0.1987和0.3450Sv±0.2152(P＜0.05);(3)在PGE1治疗组和感染对照组大鼠肝内,I型胶原的含量均与TGF-β1的含量呈显著正相关(r=0.9636,P＜0.05;r=0.8667,P＜0.05),Ⅲ型胶原的含量亦均与TGF-β1的含量呈显著正相关(r=0.9636,P＜0.05;r=0.9272,P＜0.05).结论PGE1对日本血吸虫病肝纤维化的形成有抑制作用,其机理可能与PGE1抑制TGF-β1的表达有关.     

己酮可可碱对日本血吸虫病肝纤维化小鼠肝脏TGF- β1和Ⅰ、Ⅱ型胶原表达的影响

目的　研究己酮可可碱 (pentoxifylline,PTX)对日本血吸虫病肝纤维化小鼠肝脏转化生长因子β1(TGF-β1)和 、 型胶原含量的影响。　方法　 4 0只血吸虫病肝纤维化小鼠均分 4组 ,对照组不作任何治疗。吡喹酮组 5 0 0mg/ (kg· d)治疗 2 d,高剂量 PTX组 36 0 mg/ (kg· d)治疗 8wk,低剂量 PTX组 180 mg/ (kg· d)治疗 8wk。应用免疫组化染色方法和多媒体彩色病理图文分析系统 ,观察不同剂量 PTX治疗前后肝脏 TGF-β1和 、 型胶原含量的变化。　结果　 PTX对 TGF- β1和 、 型胶原含量的影响与治疗剂量有关 ,高剂量 PTX组 TGF- β1和 、 型胶原含量明显低于对照组 (P<0 .0 1) ,而低剂量 PTX组与对照组之间差异无统计学意义 (P>0 .0 5 )。　结论　高剂量 PTX治疗血吸虫病肝纤维化小鼠可显著降低其肝脏 TGF-β1和 、 型胶原的含量。     

己酮可可碱对日本血吸虫病肝纤维化小鼠肝脏TGF- β1和 、 型胶原表达的影响

目的　研究己酮可可碱 (pentoxifylline,PTX)对日本血吸虫病肝纤维化小鼠肝脏转化生长因子β1(TGF-β1)和 、 型胶原含量的影响。　方法　 4 0只血吸虫病肝纤维化小鼠均分 4组 ,对照组不作任何治疗。吡喹酮组 5 0 0mg/ (kg· d)治疗 2 d,高剂量 PTX组 36 0 mg/ (kg· d)治疗 8wk,低剂量 PTX组 180 mg/ (kg· d)治疗 8wk。应用免疫组化染色方法和多媒体彩色病理图文分析系统 ,观察不同剂量 PTX治疗前后肝脏 TGF-β1和 、 型胶原含量的变化。　结果　 PTX对 TGF- β1和 、 型胶原含量的影响与治疗剂量有关 ,高剂量 PTX组 TGF- β1和 、 型胶原含量明显低于对照组 (P<0 .0 1) ,而低剂量 PTX组与对照组之间差异无统计学意义 (P>0 .0 5 )。　结论　高剂量 PTX治疗血吸虫病肝纤维化小鼠可显著降低其肝脏 TGF-β1和 、 型胶原的含量。     

实验性血吸虫病肝纤维化中TGF-β1 Smad3 Smad7的表达变化及意义

目的　研究 TGF-β1、Sm ad3、Smad7在血吸虫病肝纤维化家兔肝脏中的表达变化规律 ,为逆转血吸虫病肝纤维化寻找新的途径。方法　日本血吸虫尾蚴腹贴法制备家兔肝纤维化模型 (n=4 0 ) ,按诱导时间将动物随机分为 4、8、12、16周及正常对照共 5组 ,采用逆转录 -聚合酶链反应 (RT-PCR)检测肝组织中转化生长因子 TGF-β1m RNA表达水平 ,免疫组织化学检测肝组织中 、 型胶原的表达 ,且同时分别以 RT- PCR、Western blot检测原代分离肝星状细胞 (HSC)的 Sm ad3、Sm ad7m RNA和蛋白表达。结果　肝纤维化形成过程中 TGF- β1m RNA表达进行性增强 ,伴有肝组织 、 型胶原含量的明显增高 ,且分别与 、 型胶原呈显著正相关 (r1 =0 .5 36 ,P<0 .0 1;r2 =0 .5 4 4 ,P<0 .0 1) ; 、 型胶原表达在肝窦壁、中央静脉壁、Disse腔、虫卵肉芽肿内及其周围 ,呈弥漫状分布 ,伴有门管区胶原纤维隔形成和窦壁完整的基膜形成 ;与正常对照组相比 ,各期肝纤维化家兔 HSC中 Smad3m RNA表达增加 ,与 TGF- β1m RNA表达趋势基本一致。而 Sm ad7m RNA较正常对照组一过性升高 (P<0 .0 5 ) ,第 8～ 16周表达水平则持续下降 (P<0 .0 1)。 Smad蛋白表达与其m RNA改变基本一致。结论　 TGF- β1/ Smad信号通路参与了血吸虫病肝纤维化进程     

晚期血吸虫病患者血清粒细胞集落刺激因子、转化生长因子β1检测意义

目的　研究晚期血吸虫病患者血清粒细胞集落刺激因子 (G- CSF)和转化生长因子 β1(TGF- β1 )水平的改变和临床意义。方法　采用酶联免疫吸附试验 (EL ISA)检测 30例晚期血吸虫病患者 (晚血组 )和 11例急性血吸虫病患者 (急血组 )血清 G- CSF和 TGF- β1 水平 ,并与 10例正常人(正常对照组 )作对照。结果　晚血组和急血组血清 G- CSF水平显著高于正常对照组 (P<0 .0 1,P<0 .0 5 ) ;急血组血清 TGF- β1 水平显著高于正常对照组 (P<0 .0 1) ,而晚血组升高不明显 (P>0 .0 5 ) ;急血组 G- CSF与 TGF- β1 水平之间呈显著正相关 (r=0 .7118,P<0 .0 5 ) ,晚血组则无显著相关 (r=0 .1982 ,P>0 .0 5 )。结论　血清 G- CSF能反映晚血患者合并感染 ,而血清 TGF- β1 不能反映晚血肝纤维化程度     

TNF-α及其拮抗剂对血吸虫病小鼠的TGF-β1和型胶原的影响

为探索 TNF-α及其拮抗剂对血吸虫病小鼠转化生长因子β1(TGF-β1)和 型胶原的影响 ,用免疫组化计算机分析、EIA和 EL ISA检测血清和肝内 TGF-β1、 型前胶原肽 (PC )和 型胶原。结果显示 ,感染鼠肝内 TGF-β1和 型胶原主要分布在汇管区、肉芽肿内及其周围。感染后第 10 wk,未用药感染鼠血清和肝内 TGF-β1高于健康鼠 (血清 P>0 .0 5 ,肝内 P<0 .0 0 1)和注射 TNF-α感染鼠的血清和肝内 TGF-β1水平低于未用药感染鼠 (血清 P<0 .0 0 2 ,肝内 P>0 .0 5 ) ;注射抗 TNF-α感染鼠血清和肝内 TGF-β1水平则高于未用药感染鼠 (P<0 .0 5 )和注射TNF-α感染鼠 (P<0 .0 1)。同期未用药感染鼠肝内 型胶原高于健康鼠 (P<0 .0 0 1)和注射 TNF-α感染鼠 (P<0 .0 5 ) ,血清 PC 则高于健康鼠 (P<0 .0 0 1)而与后者差异不大 (P>0 .0 5 )。注射抗 TNF-α感染鼠血清 PC 和肝内 型胶原则高于未用药感染鼠 (P<0 .0 2 )和注射 TNF-α感染鼠 (P<0 .0 5～ P<0 .0 0 1)。表明 TGF-β1与胶原的增加密切相关 ,TNF-α在感染的急性期对 TGF-β1有抑制效应。血清和肝内的检测结果显示出较好的一致性     

抗纤合剂对血吸虫病肝纤维化的防治作用研究

目的 :观察抗纤合剂的抗肝纤维化作用。方法 :用日本血吸虫尾蚴感染新西兰兔 ,制成肝纤维化模型 ,病兔均以吡喹酮顿服杀虫治疗 ,继之中药组开始服用抗纤合剂治疗肝纤维化 ,并与秋水仙碱组及 0 .9%Na Cl组比较。RIA法检测血清 型前胶原 (PC )、透明质酸 (HA) ,苏木精 -伊红、天狼红染色观察胶原沉积 ,通过原位杂交检测基质金属蛋白酶 - 1(MMP- 1)和基质金属蛋白酶组织抑制剂 - 1(TIMP- 1)的表达 ,并作 、 型胶原和转化生长因子 β1 (TGF- β1 )免疫组化染色。结果 :中药组 PC 、HA水平降低 (P <0 .0 5 ) ,图像分析显示肝组织 、 型胶原和TGF- β1 表达减弱 (P <0 .0 5 ) ,肝组织 MMP- 1m RNA的表达增强 ,TIMP- 1m RNA表达减弱 (P <0 .0 5 ) ,肝纤维化程度减轻。结论 :抗纤合剂具有抗实验性血吸虫病兔肝纤维化的作用。     

热休克蛋白47在日本血吸虫病肝纤维化病程的动态变化

目的观察热休克蛋白47(heat shock protein 47,HSP47)在日本血吸虫病患者肝脏组织中的表达情况及其在日本血吸虫病肝纤维化小鼠动物模型中的动态变化。方法收集2008—2012年期间同济医院门诊和住院部日本血吸虫病肝纤维化患者肝穿标本72例。用免疫组织化学法检测HSP47表达;Masson染色观察胶原增生情况;实时荧光定量PCR检测HSP47、Ⅰ型胶原、结缔组织生长因子(connective tissue growth factor,CTGF)及转移生长因子-β1(transforming growth factor-β1,TGF-β1)m RNA水平的表达。构建实验性日本血吸虫病肝纤维化小鼠模型,分别于感染后第6、8、12周取小鼠肝组织,用免疫组织化学法检测HSP47表达,采用实时荧光定量PCR及Western blot检测HSP47的m RNA和蛋白水平表达及Ⅰ型胶原纤维增生情况。结果日本血吸虫病肝纤维化患者肝组织中的HSP47主要表达在肝脏间质细胞及虫卵结节周围,并随纤维化程度进展显著增多(P均0.01),与Ⅰ型胶原增生趋势平行。各纤维化分期患者肝组织胶原及纤维化相关因子CTGF及TGF-β1 m RNA表达均明显高于S0期无纤维化患者(P均0.01)。在肝纤维化模型小鼠中HSP47随纤维化进展其表达亦显著升高,感染后第6、8、12周,HSP47及Ⅰ型胶原的表达量均显著高于正常对照小鼠(P均0.01),同血吸虫病肝纤维化患者的表达趋势一致。结论 HSP47在日本血吸虫病肝纤维化患者和日本血吸虫病动物模型肝组织中表达均上调,且随Ⅰ型胶原、CTGF、TGF-β1增多呈相同趋势,其有望成为肝纤维化新的诊断标志和治疗靶点。     

双环醇对小鼠日本血吸虫病肝组织即早基因与TGF-β1表达的影响

目的研究双环醇对小鼠日本血吸虫病肝纤维化的治疗作用及其机制。方法80只小鼠随机分为4组。其中2组小鼠感染日本血吸虫8周后,分别以双环醇60 mg/kg.d、120 mgkg.d治疗8周,实验对照组感染日本血吸虫后不作任何治疗,第4组小鼠作为正常对照组。应用HE染色、RT-PCR及免疫组化染色法,观察和分析不同剂量双环醇治疗前后各组小鼠肝组织病理改变、c-fos mRNA、转化生长因子β1(transforming growth factorβ1,TGF-β1)和Ⅰ、Ⅲ型胶原的表达变化。结果高剂量双环醇治疗后小鼠肝纤维化组织病理损伤减轻,c-fos mRNA、TGF-β1和Ⅰ、Ⅲ型胶原含量显著低于实验对照组而高于正常对照组,低剂量双环醇对血吸虫病肝纤维化无明显治疗效果。结论双环醇治疗血吸虫病肝纤维化作用呈剂量依赖性,高剂量双环醇抗血吸虫病肝纤维化作用可能与其抑制肝组织即早基因表达、减少TGF-β1产生有关。     

秋水仙碱对血吸虫病肝纤维化小鼠肝脏Ⅰ、Ⅲ、Ⅵ型胶原蛋白表达的影响

目的　阐明秋水仙碱治疗对血吸虫病肝纤维化小鼠肝脏胶原蛋白表达的影响。方法　应用免疫组化技术 ,观察血吸虫病肝纤维化小鼠在秋水仙碱治疗前后肝脏Ⅰ、Ⅲ、Ⅵ型胶原蛋白的分布及含量 (半定量 )变化。结果　秋水仙碱治疗组小鼠与对照组相比 ,肝内Ⅰ型胶原蛋白无显著变化 ,而肝内Ⅲ型和Ⅵ型胶原蛋白的免疫组化染色均明显减弱 ;对胶原含量半定量分级亦显示两组Ⅰ型胶原含量无差异 (χ2 =2 .43,P >0 .0 5 ) ,而Ⅲ型和Ⅵ型胶原蛋白在治疗组的含量则显著下降 (X2 分别为6 .0 7,8.17,P <0 .0 5 )。结论　秋水仙碱治疗可显著降低血吸虫感染小鼠肝内Ⅲ型和Ⅵ型胶原蛋白含量 ,从而发挥其抗肝纤维化作用。     

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.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

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.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.