比索洛尔对高血压大鼠心肌成纤维细胞增殖及胶原合成的影响

目的:探讨比索洛尔对培养的高血压大鼠（SHR）和W istar大鼠心脏成纤维细胞（CFs）增殖及胶原合成的影响。方法:采用胰酶消化法培养CFs,采用3H-胸腺嘧啶核苷（3H-TdR）掺入法测定CFs的DNA合成功能,四氮唑蓝（MTT）比色法测定细胞增殖,3H-脯氨酸（3H-Proline）掺入法测定胶原合成。结果:①基础状态下,SHR组CFs的3H-Proline掺入量3、H-TdR掺入量及MTT比色法A值均明显高于W istar组。②不同浓度比索洛尔对两组大鼠CFs3H-TdR掺入量及MTT比色法A值均无明显作用。③不同浓度比索洛尔以浓度依赖的方式抑制CFs3H-Proline掺入量,与W istar大鼠组相比,SHR组CFs受抑制的效应更强。结论:SHR的CFs细胞数目、DNA合成及胶原含量均存在异常,比索洛尔呈浓度依赖性抑制CFs的胶原合成,但对CFs增殖及DNA合成无明显作用。     

卡维地洛对高血压大鼠心脏成纤维细胞胶原合成的抑制作用

目的 :探讨卡维地洛、比索洛尔、哌唑嗪对培养的 SHR和 Wistar大鼠心脏成纤维细胞 （ CFs）胶原合成的影响。方法 :采用胰酶消化法培养 CFs,用3 H-脯氨酸掺入法分别观察卡维地洛、比索洛尔、哌唑嗪干预下两组大鼠 CFs胶原合成的情况。结果 :1各种浓度的卡维地洛 （ 0 .0 1～ 10μmol/ L ）可以浓度依赖的方式抑制 CFs 3 H-脯氨酸掺入量 ,与 Wistar大鼠组相比 ,SHR组 CFs受抑制的效应更强。2同等浓度比索洛尔对两组大鼠 CFs3 H-脯氨酸掺入量表现出轻度抑制。 3同等浓度哌唑嗪对两组大鼠 CFs3 H-脯氨酸掺入量均无明显影响。结论 :卡维地洛呈浓度依赖性抑制 CFs合成胶原 ,其作用机制部分与阻滞β1 受体有关。     

糜酶对大鼠心脏成纤维细胞增殖和胶原合成的影响

目的探讨糜酶对大鼠心脏成纤维细胞（CFs）增殖和胶原合成的影响。方法用胰酶消化法分离、培养新生SD大鼠的CFs,采用MTT比色法（A490值）测定细胞数目,流式细胞术分析细胞周期,3H-脯氨酸掺入法测定总胶原合成,RT-PCR检测Ⅰ型和Ⅲ型胶原mRNA的表达。结果①糜酶以剂量依赖方式增加CFs的数目。其中15、30和60μg/L组的A490值分别为0.263±0.033、0.348±0.031和0.387±0.026,均高于对照组的A490值（0.201±0.019）,并有非常显著性差异（P<0.01）。②随着糜酶作用浓度的增加,CFs在G0/G1期的百分率逐渐减少,S期的百分率和细胞增殖指数逐渐增加。其中15、30和60μg/L组与对照组相比,上述各项指标均有显著或非常显著性差异（P<0.05或P<0.01）。③糜酶以剂量依赖方式增加CFs的3H-脯氨酸掺入量。其中15、30和60μg/L组的3H-脯氨酸掺入量分别为（520±75）、（684±62）和（769±58）cpm/孔,均高于对照组[（435±60）cpm/孔],差异有显著或非常显著性意义（P<0.05或P<0.01）。④随着糜酶作用浓度的增加,CFs的Ⅰ型和Ⅲ型胶原mRNA表达水平均呈递增趋势。其中15、30和60μg/L组的Ⅰ、Ⅲ型胶原mRNA表达的水平均显著高于对照组（P<0.01）。结论糜酶具有促进CFs增殖和胶原合成的作用,提示其可能在心肌纤维化过程中发挥重要作用。     

AngⅡ、TGF-β1和FN对自发性高血压大鼠心肌成纤维细胞合成胶原的影响

目的　观察血管紧张素Ⅱ（AngⅡ）、转化生长因子β1（TGF-β1）、洛沙坦（Losartan）、纤维粘连蛋白（FN）对培养的SHR和WKY大鼠心肌成纤维细胞（CFb）合成胶原的影响。方法　采用组织块贴壁法培养CFb,分别测定AngⅡ、TGF-β1、Losartan、FN干预下CFb的　3H-脯氨酸（　3H-Proline）掺入量。结果　AngⅡ、TGF-β1、FN促进CFb的　3H-Proline掺入量,Losartan抑制10-7MAngⅡ诱导的CFb的　3H-Proline掺入。结论　AngⅡ、TGF-β1、FN对CFb的胶原合成有促进作用,Losartan可拮抗AngⅡ的作用。     

AngⅡ、TGF—β1和FN对自发性高血压大鼠心肌成纤维细胞合成胶原的影响

目的 观察血管紧张素Ⅱ（AngⅡ）、转化生长因子β1（TGF－β1)、洛沙坦（Losartan)、纤维粘连蛋白（FN）对培养的SHR和WKY大鼠心肌成纤维细胞（CFb)合成胶原的影响。方法 采用组织块贴壁法培养CFb,分别测定AngⅡ、TGF－β1、Losartan、FN干预下CFb的^3H-脯氨酸（^3H-Proline)掺入量。结果 AngⅡ、TGF－β1、FN促进CFb的^3H-Proline掺入量,Losartan抑制10^-7M AngⅡ诱导的CFb的^3H-Proline掺入。结论 AngⅡ、TGF－β1、FN对CFb的胶原合成有促进作用,Losartan可拮抗AngⅡ的作用。     

卡维地洛、比索洛尔、哌唑嗪对SHR心肌成纤维细胞增殖作用的对比研究

目的观察卡维地洛(carvedilol)、比索洛尔(bisoprolol)、哌唑嗪(prazosin)对培养的SHR和Wistar大鼠心肌成纤维细胞(CFs)增殖的影响.方法采用胰酶消化法培养CFs,用 3H-TdR法、MTT比色法分别观察carvedilol、bisolol、prazosin干预下CFs的增殖情况.结果 SHR、Wistar大鼠CFs 3H-TdR掺入及OD值随carvedilol浓度的增加而减低,呈剂量和时间依赖性.10-5 mol /L carvedilol分别干预SHR和Wistar大鼠CFs 72 h其 3H-TdR掺入分别减低52.1%和47.5%,OD值分别减低41.5% 和 35.3%, bisolol(10-8 mol/L～10-5mol/L )和prazosin(10-8 mol/L～10-5 mol/L)则无此作用.结论 Carvedilol抑制心肌成纤维细胞增殖,并呈浓度及时间依赖性,高血压时,CFs对Carvedilol更为敏感.而Bisoprolol和Prazosin则对CFs细胞增殖无影响.     

吡格列酮对自发性高血压大鼠心脏成纤维细胞周期的影响

目的研究盐酸吡格列酮对培养的自发性高血压大鼠（SHR）和血压正常大鼠（WKY）心脏成纤维细胞（CFs）细胞周期的影响,并进一步探讨其与NO-NOS系统的关系。方法采用胶原酶消化法培养SHR和WKY的CFs,流式细胞仪（FCM）分析技术检测细胞周期,硝酸还原酶法测定CFs培养上清NO浓度,分光光度法测定CFs培养上清NOS活性。结果0.1、1、5和10μmol/L的吡格列酮作用48h后,SHR、WKY CFs的G0/G1期细胞百分率较对照组显著增高（均P<0.01）,S期细胞百分率、G2/M期细胞百分率和增殖指数则显著低于对照组（P<0.01,P<0.05）,且随着作用浓度的增加,吡格列酮对细胞周期的影响逐渐增强。5μmol/L的吡格列酮干预48 h后,SHR和WKY的CFs培养上清NO浓度分别为（111.2±12.4）μmol/L和（221.7±35.3）μmol/L,与各自对照组（76.8±2.4）μmol/L、（112.1±8.9）μmol/L相比,差异非常显著（P<0.01）;SHR和WKY大鼠CFs培养上清NOS活性分别为（208±18）μkat/L、（257±30）μkat/L,和各自对照组（148±10）μkat/L、（187±8）μkat/L相比,亦有非常显著性差异（P<0.01）。NO浓度和NOS活性呈显著正相关（r=0.964,P<0.01）。结论吡格列酮能够抑制SHR CFs的细胞周期增殖,其效应可能与上调NO-NOS系统活性有关。     

丝裂原活化蛋白激酶在醛固酮诱导心室成纤维细胞增殖中的作用

目的:探讨醛固酮诱导心肌成纤维细胞(CFs)增殖的信号转导机制.方法:用胰酶消化法分离、培养新生大鼠CFs,采用3H-胸腺嘧啶核苷(3H-TdR)掺入法、western-blotting技术从DNA合成、蛋白表达等方面观察MAPK活化与醛固酮促CFs增殖的关系.结果:①醛固酮剂量依赖性促CFs DNA合成,10-5mol/L PD98059 [(782±152)个·min-1] 可逆转 10-7mol/L醛固酮 [(1879±169)个·min-1]的作用;②10-7mol/L醛固酮对活化MAPK蛋白表达有显著增强作用,在4 h达峰作用(8.11±0.46),10-7mol/L 醛固酮的作用(8.11±0.46)被10-5mol/L PD98059 (1.21±0.10, P<0.01)阻断.结论:醛固酮能激活CFs的MAPK,MAPK表达及活化参与醛固酮诱导的CFs增殖.     

过氧化物酶增殖物激活受体α激动剂对心脏成纤维细胞增殖的抑制作用

目的: 探讨过氧化物酶增殖物激活受体α（PPARα）激动剂非诺贝特(fenofibrate)对糜酶介导的大鼠心脏成纤维细胞（CFs）增殖的影响及作用机制。方法: 用胰酶消化法分离、培养新生SD大鼠的CFs。采用3H-脱氧胸腺嘧啶核苷（3H-TdR）掺入法测定CFs的DNA合成,用流式细胞术分析细胞周期,用RT-PCR检测PPARα 及转化生长因子β1（TGF-β1）mRNA的表达。结果: ①以不同浓度的非诺贝特预处理后,CFs的3H-TdR掺入量呈浓度依赖性减少,其中50和100 μmol/L组均较糜酶组明显减少（分别为P<0.05和P<0.01）。②随着非诺贝特浓度的增加,CFs在G0/G1期的百分率逐渐增加,S期的百分率和增殖指数逐渐减少,其中50和100 μmol/L组与糜酶组比较,上述各项指标均有显著性差异（分别为P<0.05和P<0.01）。③以25、50和100 μmol/L非诺贝特预处理后,PPARα mRNA表达的水平呈浓度依赖性增加,其中50和100 μmol/L组均较糜酶组显著增加（分别为P<0.05和P<0.01）。④随着非诺贝特浓度的增加,TGF-β1 mRNA表达水平呈递减趋势,其中50和100 μmol/L组均较糜酶组明显减少（P<0.01）。结论: PPARα 激动剂非诺贝特以浓度依赖的方式抑制糜酶诱导的大鼠CFs增殖的作用,其机制与PPARα基因表达的上调和TGF-β1基因表达的下调有关,提示PPARα 和TGF-β1这两条信号通路可能存在信息交流。     

人参皂苷Rg3对血管紧张素Ⅱ诱导小鼠心肌成纤维细胞增殖及胶原合成的影响

目的 研究人参皂苷Rg3对血管紧张素(Ang)Ⅱ诱导的小鼠心肌成纤维细胞(CFs)增殖与胶原合成的影响,探讨人参皂苷Rg3是否具有对抗心肌纤维化的作用。方法 用胰酶消化,差速贴壁、分离纯化CFs,用波形蛋白(Vimentin)免疫荧光法鉴定CFs;建立AngⅡ诱导的CFs增殖模型。实验分为正常对照组(无血清DMEM),模型组(AngⅡ),人参皂苷Rg3组共3组;人参皂苷Rg3预处理1 h,加入AngⅡ共同作用24 h,采用EdU试剂盒检测CFs的增殖情况;羟脯氨酸法检测细胞胶原分泌水平;Western印迹检测CFs中增殖细胞核抗原(PCNA)、胶原蛋白(Col)Ⅰ的表达情况。结果 成功提取新生大鼠原代CFs, Vimentin显著阳性;与正常对照组比较,模型组CFs增殖和胶原分泌明显增加,PCNA、ColⅠ蛋白表达水平明显升高;与模型组相比,人参皂苷Rg3组CFs增殖和胶原分泌水平较明显降低,PCNA、ColⅠ蛋白表达水平明显降低。结论 人参皂苷Rg3通过抑制AngⅡ诱导的CFs增殖和胶原蛋白合成,进而发挥抗心肌纤维化作用。     

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。