阿司匹林预处理对大鼠局灶性脑缺血再灌注损伤的神经保护作用

目的探讨阿司匹林预处理对大鼠局灶性脑缺血再灌注损伤的保护作用机制。方法SD大鼠随机分为假手术组、脑缺血再灌注组、阿司匹林预处理组。各组采用大脑中动脉线栓法制备缺血再灌注损伤实验动物模型。比较各组神经功能缺失评分、脑梗死体积、血清神经元烯醇化酶(NSE)含量及脑组织白细胞介素-1β(IL-1β)和肿瘤坏死因子(TNF-α)含量。结果阿司匹林预处理组可使神经功能缺损减轻、脑梗死体积缩小、血清NSE含量降低,均较脑缺血再灌注组明显。同时脑组织IL-1β和TNF-α含量亦较脑缺血再灌注组降低。结论阿司匹林预处理可诱导脑缺血耐受作用,其机制可能与下调脑组织再灌注损伤时IL-1β和TNF-α的表达有关。     

缺血预处理对大鼠脑缺血再灌注损伤保护作用的探讨

目的探讨缺血预处理对大鼠脑缺血再灌注损伤的保护作用及其机制。方法SD大鼠随机分为三组,分别为假手术组、脑缺血再灌注组、脑缺血预处理组。各组采用Longa等的大脑中动脉线栓法并加以改进,制备缺血预处理及缺血再灌注损伤实验动物模型。比较各组神经功能缺失评分、脑梗死体积、血清NSE含量及脑组织IL-1β和TNF-α含量。结果脑缺血预处理可使神经功能缺损减轻、脑梗死体积缩小、血清NSE含量降低,脑组织IL-1β和TNF-α含量降低。结论缺血预处理可诱导脑缺血耐受作用的产生,下调脑组织再灌注损伤时IL-1β和TNF-α的表达,对脑缺血再灌注损伤具有保护作用。     

缺血后处理下调脑缺血再灌注大鼠白细胞介素-1β和肿瘤坏死因子-α表达

目的 探讨缺血后处理(ischemic postconditioning,IP)对局灶性脑缺血再灌注大鼠白细胞介素-1β(interleukin- 1β,IL-1β)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)表达的影响.方法 110只成年健康雄性Sprague-Dawley大鼠随机分为假手术组(n=10)、缺血再灌注组和IP组,后2组根据再灌注时间再分为6、12、24、48和72 h亚组(每亚组n=10).采用大脑中动脉线栓法建立局灶性脑缺血再灌注模型.IP方法为在大脑中动脉闭塞2h后实施再灌注15 s/缺血15 s,反复3次.对各组大鼠进行神经行为学评分,2,3,5-氯化三苯基四氮唑染色测定脑梗死体积,免疫组化法检测脑组织TNF-α和IL-1β蛋白表达,原位杂交法检测IL-1β和TNF-α mRNA表达.结果 与缺血再灌注组比,IP组神经行为学评分显著降低(P均＜0.05),脑梗死体积显著缩小(P均＜0.05).假手术组额顶叶皮质IL-1β、TNF-α蛋白和mRNA表达微弱;缺血再灌注组IL-1β、TNF-α蛋白和mRNA在额顶叶皮质大量表达,6h开始上调,24 h达高峰(与其他时间点比较,p均＜0.05),之后逐渐下降;IP组具有相同的动态变化趋势,且各时间点表达量均显著低于缺血再灌注组(P均＜0.05).结论 IP可显著下调脑组织IL-1β和TNF-α表达,缩小缺血再灌注大鼠脑梗死体积,提示IP可通过抑制脑组织缺血再灌注后炎症反应发挥神经保护作用.     

糖尿病通过炎症反应加重大鼠脑缺血再灌注损伤

目的：探讨肿瘤坏死因子-α（tumornecrosisfactor-α,TNF-α）和核因子-κB（nuclear factor-κB, NF-κB）在糖尿病大鼠缺血再灌注损伤中的作用。方法36只健康雄性Sprague-Daw ley大鼠按随机数字表法分为正常血糖假手术组、正常血糖脑缺血再灌注组和糖尿病脑缺血再灌注组,每组12只。采用腹腔注射链脲佐菌素制作大鼠糖尿病模型,然后应用栓线法建立局灶性脑缺血再灌注模型,再灌注24 h行神经功能缺损评分,然后2,3,5-氯化二苯四氮唑染色检测脑梗死面积,蛋白质印迹法检测缺血侧皮质NF-κB和TNF-α表达水平。结果正常血糖假手术组、正常血糖脑缺血再灌注组和糖尿病脑缺血再灌注组神经功能评分分别为（0.00±0.00）分、（2.50±1.08）分和（3.20±1.03）分,差异有统计学意义（F=38.015,P<0.001）,且糖尿病脑缺血再灌注组神经功能缺损评分较正常血糖脑缺血再灌注组显著性加重（ P<0.05）。正常血糖假手术组、正常血糖脑缺血再灌注组和糖尿病脑缺血再灌注组梗死面积分别为（0.00±0.00）％、（33.09±5.17）％和（55.45±9.29）％,各组间差异有统计学意义（F=206.614,P<0.001）,其中糖尿病脑缺血再灌注组梗死面积较正常血糖脑缺血再灌注组显著性增大（P<0.05）。再灌注后24 h,各组缺血侧皮质NF-κB（F=29.993,P<0.001）和TNF-α（F=28.722,P<0.001）表达水平差异有统计学意义,其中糖尿病脑缺血再灌注组NF-κB和TNF-α表达水平较正常血糖脑缺血再灌注组显著性增高（P均<0.05）。结论糖尿病会加重脑缺血再灌注损伤,TNF-α和NF-κB表达上调可能是糖尿病加重脑缺血再灌注损伤的机制之一。     

不同预处理方式对大鼠局灶性脑缺血再灌注损伤的神经保护作用

目的探讨不同预处理方式,即缺血预处理及药物预处理(阿司匹林及中药大黄素甲醚)对大鼠脑缺血再灌注损伤的保护作用及可能的作用机制。方法 SD大鼠随机分为5组,分别为假手术组、脑缺血再灌注组、脑缺血预处理组、阿司匹林预处理组及中药大黄素甲醚预处理组。各组以线栓法建立大鼠左侧大脑中动脉缺血再灌注损伤及缺血预处理实验动物模型,给予各组大鼠不同预处理方式,比较各组神经功能缺失评分、脑梗死体积、血清神经无特异性烯醇化酶(NSE)含量及脑组织白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)含量。结果脑缺血预处理、药物预处理均可使神经功能缺损减轻、脑梗死体积缩小、血清NSE含量降低,且药物预处理中大黄素甲醚预处理较阿司匹林预处理效果更为明显,同时脑组织IL-1β和TNF-α含量降低亦更为明显。结论药物预处理与缺血预处理同样可诱导脑缺血耐受现象,对局灶性脑缺血再灌注损伤起到保护作用,且中药大黄素甲醚效果更加明显,其机制可能与下调脑组织再灌注损伤时IL-1β和TNF-α的表达有关。     

苯妥英对局灶性脑缺血——再灌注后脑组织自由基含量的影响

目的观察大鼠局灶性脑缺血-再灌注后脑组织自由基的变化及苯妥英（PHT）对其改善的影响．并探讨其保护作用机制。方法将雄性成年Wistar大鼠随机分为4组：即假手术组、缺血-再灌注组、PHT低剂量治疗组和PHT高剂量治疗组。采用线栓法制成大脑中动脉闭塞模型，每组均于手术后6h、12h、24h三个时间点测定脑组织超氧化物歧化酶（SOD）活力和丙二醛（MDA）水平的改变。结果缺血-再灌注组各时点SOD活力显著低于假手术组相应时点SOD活力（P〈0．05），PHT低剂量治疗组和高剂量治疗组SOD活力明显高于缺血-再灌注组各时点SOD活力（P〈0.05），PHT高剂量治疗组各时点SOD活力又明显高于低剂量治疗组，且具有显著性差异（P〈0．05）；缺血-再灌注组MDA水平显著高于假手术组相应时点MDA水平（P〈0.05），PHT低剂量治疗组和高剂量治疗组MDA水平与缺血-再灌注组各相应时间点比较明显降低（P〈0．05），PHT高剂量治疗组MDA水平与PHT低剂量治疗组各相应时间点比较明显降低（P〈0.05）。结论脑缺血-再灌注后，缺血大鼠脑组织内的MDA的水平升高，SOD活力降低，说明自由基参与了脑缺血-再灌注损伤的病理生理过程。PHT可降低MDA的水平，增加SOD的活性，从而对脑缺血-再灌注损伤具有保护作用。     

槲皮素对缺血再灌注大鼠肝脏损伤的保护作用

目的评估槲皮素对缺血再灌注大鼠肝脏损伤大鼠的保护作用。方法健康大鼠80只被随机分为对照组5只、假手术组25只、缺血再灌注组25只和槲皮素组25只,后3组再按不同灌注时限(0、6、12、24、72 h)分为5个亚组,每个亚组5只。分别于实验结束后留取大鼠血液及肝脏组织,用全自动生化分析仪检测血清中ALT、AST水平,竞争抑制ELISA法检测血清中IL-1β、IL-6、IL-8、TNF-α水平;HE染色法观察肝脏的形态学改变,并用原位末端标记法检测肝脏细胞的凋亡情况。结果肝脏缺血再灌注组各时点血清中ALT、AST、IL-1β、IL-6、IL-8、TNF-α均有所升高,且以12 h最高,与对照组、假手术组相比差异有统计学意义(P均<0.05);除IL-6外,槲皮素组各时点以上检测指标与缺血再灌注组比较有统计学差异(P均<0.05)。光镜下,对照组、假手术组肝脏无明显改变;而在缺血再灌注后12 h,肝细胞变性明显,肝索结构消失,部分肝细胞灶状坏死;槲皮素组的肝脏仅部分细胞变性,部分肝索结构存在,该形态学变化与细胞凋亡指数的检测结果一致。结论槲皮素能够有效地改善大鼠肝脏缺血再灌注损伤。     

不同时间阿司匹林预处理对大鼠局灶性脑缺血再灌注损伤的神经保护作用

目的探讨阿司匹林预处理对脑缺血再灌注损伤的保护作用机制并寻找有效预处理的产生时间及持续时间。方法将70只健康雄性SD大鼠,随机分为假手术组(n=10)、缺血再灌注对照组(n=10)和阿司匹林预处理组(n=50)。阿司匹林预处理组又分为5个亚组,每组10只,分别于预处理后即刻、3h、1、3、5d行大脑中动脉闭塞,以线栓法闭塞大脑中动脉制作脑缺血再灌注模型。局部脑缺血2h,于再灌22h观察阿司匹林对神经功能缺失评分、脑梗死体积、病变侧脑组织白细胞介素-1β(IL-1β)及肿瘤坏死因子-α(TNF-α)含量的影响。结果与缺血再灌注对照组比较,阿司匹林预处理后3h、1、3d组脑神经功能缺失评分降低,脑梗死体积缩小,IL-1β和TNF-α含量减低。结论阿司匹林预处理对随后的脑缺血再灌注损伤具有保护作用,其机制可能与减少IL-1β和TNF-α的过量表达有关,这种保护作用产生于预处理后3h,1d达峰,持续至第3d。     

扶芳藤合剂预防给药对大鼠脑缺血再灌注后肿瘤坏死因子-α表达的影响

目的 观察扶芳藤银杏叶舍剂对急性脑缺血再灌注后肿瘤坏死因子-α（TNF—α）表达水平的影响。方法 将大鼠随机分为假手术组、缺血苒灌注组、扶芳藤银杏叶合剂预防给药加缺血再灌注组（药物组）。采用大脑中动脉缺血再灌注模型，用免疫组化法检测脑组织缺血再灌注2h、6h、12h、24h后TNF—α的表达水平的变化。结果 TNF—α在缺血再灌注组表达明显，随缺血再灌注时间的延长，TNF-α水平亦随时间增加。在缺血再灌注同一时间段内，药物组TNF—α均明显低于缺血再灌注组（P〈0．01）结论 扶芳藤银杏叶合剂可能通过降低急性脑缺血再灌注后TNF—α的表达水平，以达到减轻急性脑缺血后脑细胞的损伤作用的目的。     

缺血后处理抑制TLR2信号通路对大鼠缺血再灌注脑损伤的保护作用

目的研究缺血后处理对局灶性缺血和再灌注所造成脑损伤和神经炎症的影响。方法将成年雄性Wistar大鼠随进分为假手术组、局灶性缺血组、缺血后处理组。通过大脑中动脉闭塞术制备局灶性缺血,缺血后处理即在缺血后2 h进行3次30 s/30 s的再灌注/再阻塞。对脑梗死体积、神经系统功能、肿瘤坏死因子(TNF)-α和白细胞介素(IL)-1β的转录水平、TNF-α、IL-1β和TLR2的表达水平进行检查。结果缺血后处理组的脑梗死体积显著小于局灶性缺血组,神经系统功能也得到显著改善。此外,缺血后处理组抑制了TNF-α和IL-1β的转录,及TNF-α、IL-1β和TLR2的表达。结论缺血后处理组可以保护由局灶性缺血/再灌注造成的脑损伤并改善其神经系统功能,这与TNF-α和IL-1β转录的弱化,及TNF-α、IL-1β、TLR2表达的抑制有关。     

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.     

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.     

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.     

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.