缺血后处理对高血脂大鼠缺血/再灌注心肌Caspase-3活性的影响

目的：观察缺血后处理对高血脂大鼠缺血再灌注心肌Caspase（半胱氨酸天冬氨酸酶）-3活性的影响。方法：选择高血脂SD大鼠48只,随机分为3组：假手术组（开胸后穿线做套环,但不收紧结扎线）、缺血再灌注组（收紧结扎线缺血40min,放松结扎线再灌注240min）、缺血后处理组（缺血40min后,再灌注10s,缺血10s,连续3个循环,然后再灌注240min）,每组16只。再灌注结束后自右颈动脉采血,测定血清肌酸激酶（CK）活性,再灌注心肌凋亡程度,及Caspase-3活性,并进行比较分析。结果：再灌注结束后,①缺血后处理组和缺血再灌注组CK活性明显高于假手术组[（745.26±62.18）U/L比（926.38±76.49）U/L比（237.67±21.82）U/L],缺血后处理组明显低于缺血再灌注组（P均〈0.05）;②心肌凋亡细胞计数：假手术组未见明显细胞凋亡（〈5%）,缺血后处理组心肌细胞凋亡率明显低于缺血再灌注组[（11.7±2.6）%比（20.8±3.4）%,P〈0.05];③缺血后处理组缺血区心肌组织Caspase-3活性明显低于缺血再灌注组[（545.79±98.25）μmol PNA/mg比（739.83±113.57）μmol PNA/mg,P〈0.01]。结论：缺血后处理可以减轻高血脂大鼠缺血再灌注损伤,其心肌保护作用可能与降低Caspase-3活性有关。     

ATP后适应对大鼠心肌缺血再灌注损伤的保护作用

目的观察三磷酸腺苷（ATP）后适应及ATP后适应不同给药方式对大鼠在体心肌缺血再灌注损伤（MI-RI）的影响。方法采用结扎大鼠左冠状动脉前降支30 min、再灌注120 min的方法复制大鼠心肌MIRI模型。实验动物随机分为假手术组、缺血再灌注组、ATP后适应组,ATP后适应＋再灌注早期给药组。实验终点测定心肌梗死面积,观察血清丙二醛（MDA）及总超氧化物歧化酶（T-SOD）含量变化,应用免疫组化法测定组织中NF-κB的表达,TUNEL法检测心肌细胞凋亡指数。结果与缺血再灌注组相比,ATP后适应组心肌梗死面积明显缩小,血清MDA含量降低,NF-κB表达降低,心肌细胞凋亡指数降低,血清T-SOD含量升高（P〈0.05或〈0.01）;ATP后适应组和ATP后适应＋再灌注早期给药组的各项指标无统计学差异（P〉0.05）。结论 ATP后适应对心肌MIRI有保护作用,其机制可能与抗氧自由基损伤、抑制缺血再灌注后NF-κB过度表达及减少心肌细胞凋亡有关。     

恒定磁场对大鼠心肌缺血/再灌注损伤的影响

目的观察恒定磁场干预对大鼠心肌缺血/再灌注（I/R）损伤的影响。方法雄性SD大鼠24只,随机分为4组,每组6只,即假手术组、I/R组、50mT恒定磁场+I/R组及100mT恒定磁场+I/R组。大鼠麻醉开胸,结扎冠状动脉前降支40min,再灌注4h。采用Evan’s蓝和TTC染色法测定心肌梗死范围;用TUNEL法测定大鼠心肌组织细胞的凋亡;采用全自动生化分析仪测定血清肌酸激酶（CK）的水平,采用微粒子化学发光法测定血清肌钙蛋白I（cTnI）的水平。结果50mT及100mT恒定磁场干预组I/R后,心肌梗死面积和细胞凋亡指数均显著小于I/R组（P<0.05）。I/R组大鼠血清CK和cTnI的水平与假手术组比较显著升高（P<0.05）;而不同强度的恒定磁场干预+I/R组血清CK和cTnI的水平与I/R组比较显著降低（P<0.05）。结论恒定磁场干预能有效地抑制I/R所致大鼠心肌的损伤。     

芪丹通脉片对大鼠缺血/再灌注损伤心肌细胞GLUT4的影响

目的探讨中药复方芪丹通脉片对大鼠缺血/再灌注损伤（RMMI）心肌细胞葡萄糖转运蛋白（GLUT4）的影响。方法选用雄性SD大鼠36只,随机分为6组（n=6）,即正常组、假手术组、单纯模型组、芪丹通脉片高剂量组和低剂量组、恬尔心组,各组均用生理盐水配制成等体积药液灌胃7d,每日1次,采用冠脉结扎的方法建立大鼠心肌缺血/再灌注模型,将大鼠冠状动脉左前降支完全闭塞40min,再灌注4h后,速取再灌注区心肌组织,用免疫荧光、Western blot方法检测心肌细胞GLUT4的表达。结果单纯模型组心肌细胞膜GLUT4蛋白明显表达,细胞中总的GLUT4含量较正常组增加;芪丹通脉片高剂量组和恬尔心组心肌细胞膜GLUT4蛋白表达明显增强,细胞中总的GLUT4含量较单纯模型组增加。结论芪丹通脉片能明显增强RMMI大鼠心肌细胞总GLUT4的表达,并促进其向细胞膜转位,从而起到保护RMMI心肌的作用。     

缺血预处理对心肌缺血再灌注诱发凋亡的保护机制

目的：通过观察心肌细胞凋亡指数与心肌中Fas、C-fOS表达阳性率的变化,探讨缺血预处理对心肌缺血再灌注诱发细胞凋亡的保护作用及与心肌中Fas、c-fos基因表达的关系. 方法：将入选大鼠随机分为假手术对照组（A组）、缺血组（B组）、缺血再灌注组（C组）、缺血预处理组（D组）,每组15只,测定各组大鼠心肌中细胞凋亡和Fas、c-fos的表达,并分析三者之间的相关性. 结果：与A组比较,B、C及D组大鼠的心肌凋亡指数、心肌中Fas与c-fos的阳性率均升高（P＜0.01）;与C组比较,B组及D组大鼠的心肌凋亡指数、心肌中Fas与C-fOS的阳性率均降低（P＜0.01）.Pearson相关分析显示心肌凋亡指数、Fas、c-fos三者之间存在显著正相关. 结论：缺血预处理可能通过下调凋亡相关基因Fas、c-fos的表达,减少细胞凋亡而发挥心肌保护作用.     

芪丹通脉片对大鼠心肌缺血/再灌注乳酸脱氢酶及氧自由基的影响

目的探讨芪丹通脉片对大鼠心肌缺血/再灌注损伤（RMMI）的防治及其作用机制。方法选用SD大鼠36只,随机分为6组（n=6）,即假手术组、模型组、芪丹通脉片低剂量组、中剂量组和高剂量组、恬尔心组,用生理盐水配制等体积药液灌胃14 d,1次/d。造成大鼠心肌缺血/再灌注模型,检测各组大鼠乳酸脱氢酶（LDH）和超氧化物歧化酶（SOD）活性及丙二醛（MDA）含量。结果与假手术组比较,模型组大鼠LDH活性、MDA含量显著升高,SOD活性显著下降（P<0.05）。与模型组比较芪丹通脉片各剂量组、恬尔心组LDH活性、MDA含量显著下降,SOD活力显著上升（P<0.05）。结论芪丹通脉片对大鼠RMMI有显著的保护作用,可能与其有效地消除或抑制氧自由基的损伤有关。     

芪丹通脉片及拆方对脑缺血再灌注后神经细胞凋亡及Bcl-2蛋白表达的影响

目的探讨芪丹通脉片及其拆方对脑缺血再灌注损伤神经细胞凋亡及Bcl-2蛋白表达的影响,并研究方剂配伍的意义。方法用线栓法制备大鼠局灶性脑缺血再灌注模型,分为假手术组、模型组、芪丹通脉片总方组与黄芪组、活血组。末端脱氧核糖核酸转移酶介导的原位末端标记法(TUNEL法)检测各组大鼠脑组织神经细胞凋亡,免疫组织化学法检测Bcl-2蛋白的表达。结果与假手术组比较,模型组凋亡神经细胞及Bcl-2蛋白阳性细胞表达增高(P<0.01)。与模型组比较,芪丹通脉片总方组与黄芪组、活血组凋亡神经细胞表达降低,Bcl-2蛋白阳性细胞表达增多(P<0.01),且与拆方组比较,总方组的作用最强(P<0.01)。结论芪丹通脉片及其拆方可能通过上调Bcl-2蛋白的表达抑制神经细胞凋亡,对脑缺血再灌注损伤有明显的保护作用。芪丹通脉片总方组的作用明显优于黄芪组、活血组。     

缺血后处理对高血脂大鼠缺血/再灌注心肌的保护作用

目的 观察缺血后处理对高血脂大鼠缺血/再灌注（I/R）心肌的保护作用。方法 选择高血脂SD大鼠36只,随机分为3组,即假手术组、I/R组和缺血后处理组,每组12只。制备大鼠心肌I/R模型。I/R组:收紧结扎线缺血40 min,放松结扎线再灌注240 min。缺血后处理组:缺血40 min后,再灌注10 s,缺血10 s,连续3个循环,然后再灌注240 min。假手术组:开胸后穿线做套环,但不收紧结扎线。用全自动生化仪测定血清肌酸激酶（CK）的含量,黄嘌呤氧化酶法检测超氧化物岐化酶（SOD）的活性。采用硫代巴比妥酸法测定丙二醛（MDA）的含量,用伊文氏蓝-红四氮唑（TTC）染色法测定心肌梗死的范围。结果 ①血清CK活性的测定:再灌注结束后,缺血后处理组和I/R组的活性CK的活性明显高于假手术组［分别为（712.94±20.68）、（946.58±27.43） vs （232.12±18.26）U/L,P<0.05,1 U=16.67 nkat］,缺血后处理组明显低于I/R组(P<0.05)。②血清SOD和MDA的含量:缺血后处理组血清SOD 的含量高于对照组(P<0.05);MDA的含量明显低于对照组(P<0.05)。③心肌梗死范围:再灌注结束后,缺血后处理组和I/R组的心肌缺血区与左室面积的比率无明显差异。缺血后处理组的心肌坏死区与缺血区的比率显著低于I/R组［分别为(25.3±6.6）% vs （39.2±7.1）%,P<0.05］。结论 缺血后处理对高血脂大鼠I/R心肌具有保护作用。     

温阳通脉方预处理对心肌缺血再灌注大鼠MDA及SOD的影响

目的 观察温阳通脉方预处理对大鼠心肌缺血再灌注损伤（IR）模型丙二醛（MDA）、超氧化物歧化酶（SOD）含量的影响，探讨温阳通脉方对大鼠再灌注心肌的保护机制。方法 采用结扎大鼠冠状动脉左前降支，缺血30min，再灌注120min的方法建立心肌缺血再灌注损伤模型；缺血5min，再灌注5min，反复3次后缺血30min，再灌注120min建立心肌缺血预适应（IP）模型。检测大鼠灌胃14d后温阳通脉方组、心肌缺血预适应组（IP组）、再灌注损伤纽（IR组）、假性处理组血清MDA、SOD含量。结果 温阳通脉方组、IP组MDA含量低于IR组，SOD高于IR组，差异有统计学意义（P〈0．05）。结论 温阳通脉方预处理后，能降低大鼠心肌缺血再灌注损伤模型MDA含量，升高SOD含量，减轻大鼠急性心肌缺血所致心肌损伤，其机制可能是通过模拟心肌缺血预适应参与心肌保护作用。     

辛伐他汀预处理对大鼠局灶性脑缺血再灌注时间窗的影响

目的研究辛伐他汀预处理对大鼠局灶性脑缺血不同灌注时间窗的脑保护作用;探讨药物干预再灌注时间窗的可行性。方法线栓法制作大鼠缺血再灌注损伤模型,实验随机分为假手术组（A组）、缺血组（B组）、缺血/再灌注组（C组）、缺血/再灌注组加辛伐他汀组（D组）。C组、D组又各分为MCAO术后2h、4h、6h再灌注组。在完成预定操作后进行神经功能评分优于B组,测梗死体积,脑组织病理变化情况。结果D组各时间点神经功能评分优于B组,梗死体积小于B组（P〈0.05或P〈0.01）,脑组织病理变化改善。结论辛伐他汀预处理可改善神经功能评分,缩小梗死体积,改善脑组织病理变化,延长再灌注时间窗。     

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.