芪红合剂对肾间质纤维化模型大鼠的实验研究

目的探讨芪红合剂对肾间质纤维化的防治作用。方法采用单侧输尿管结扎致肾间质纤维化动物模型,以公认有肾脏保护作用的血管紧张素转换酶抑制剂(ACEI)为阳性对照,测血肌酐(Scr)、尿素氮(BUN),免疫组织化学法测肾组织纤维蛋白溶解酶原激活物抑制因子(PAI)-1、纤维连接蛋白(FN)的表达。结果芪红合剂能降低血BUN、Scr水平,显著抑制PAI-1、FN的表达,减轻肾间质纤维化程度。PAI-1分别与FN、肾间质纤维化面积显著相关。肾间质纤维化面积分别与BUN、Scr相关。结论芪红合剂有早期防治肾间质纤维化作用。     

福辛普利对慢性肾功能衰竭幼鼠凝血纤溶变化的干预影响

目的探讨血管紧张素转换酶抑制剂(ACEI)——福辛普利干预治疗对幼年大鼠慢性进展性肾脏病变过程中肾组织组织型纤溶酶原激活物(tPA)、组织型纤溶酶原激活物特异性抑制剂(PAI)-1蛋白表达的影响。方法以5/6肾切除SD大鼠为实验动物模型,予ACEI治疗12周后分别检测大鼠体重、血压、血尿生化及残肾组织常规病理和用免疫组织化学染色定性定量评价残肾tPA、PAI-1蛋白表达。结果于5/6肾切除后,大鼠肾功能进行性丧失,表现为尿蛋白、血压、血尿素氮(BUN)、肌酐(Scr)及血脂增高,残肾组织出现肾小球硬化和间质纤维化。免疫组织化学染色提示肾组织PAI-1表达增高,而tPA表达下降。经ACEI治疗后,大鼠肾功能改善、血压下降、尿蛋白下降、残肾组织tPA蛋白表达增加、PAI-1表达下降。结论ACEI具有改善5/6肾切除大鼠凝血纤溶系统紊乱的作用。     

幼鼠残肾组织凝血酶敏感蛋白-1介导凝血纤溶与肾纤维化的相关研究

目的探讨在幼年性慢性进展性肾脏病不同时间点肾组织凝血酶敏感蛋白(TSP)-1表达对肾组织凝血纤溶系统的影响,及其与肾纤维化的相关性。并探讨血管紧张素转换酶抑制剂(ACEI)的干预作用。方法用5/6肾切除残肾幼年大鼠为模型,分为不治疗组、治疗组、假手术组。于实验开始,4、8、12周为时间点,检测体质量、血压、尿蛋白定量(24h)等。用免疫组织化学法检测TSP-1、血浆凝血酶原激活物抑制物(PAI)-1、转化生长因子(TGF)-β1、尿激酶型纤溶酶原激活物(uPA)、组织型纤溶酶原激活物(tPA)的表达趋势。分析上述指标在病变进展过程中的变化特点及相关性。判断ACEI的干预效果。结果不治疗组残肾组织中tPA和uPA的表达较假手术组减少,PAI-1的表达增加。治疗后大鼠残肾组织中tPA、uPA表达明显增加,PAI-1表达明显减少。5/6肾切除大鼠各组残肾组织中TSP-1和TGF-β1的表达较假手术组上调,且呈同步上调趋势,治疗组TSP-1和TGF-β1表达则明显趋于下调,治疗组残肾组织TSP-1表达在组织定位上与肾小球硬化和肾小管间质纤维化趋势呈正相关,TSP-1表达与TGF-β1和PAI-1表达呈明显正相关,与uPA和tPA表达呈负相关。结论TSP-1和TGF-β1是促进肾纤维化的重要因子,TSP-1高表达通过影响tPA、uPA、PAI-1及其平衡导致肾组织凝血纤溶系统平衡发生紊乱而促进病变发展。     

苯那普利对肾病幼鼠纤溶蛋白肾组织定位表达的影响

目的　探讨肾病幼年大鼠肾小球硬化及肾间质纤维化病变进展过程中 ,肾组织尿激酶型纤溶酶原激活物 (u PA )、组织型纤溶酶原激活物 (t PA)及其特异性抑制物 (PAI- 1)蛋白定位表达的特点 ,及予血管紧张素转换酶抑制剂 (ACEI)——苯那普利 (benazepril;lotensin)治疗的影响。方法　采用阿霉素诱导的肾病大鼠为动物模型 ,予 ACEI治疗 12周后测大鼠体重、血压、尿蛋白、及血生化各项指标的变化 ,同时用免疫组织化学染色等方法检测各组肾组织 u PA、t PA和 PAI- 1的蛋白表达的变化特点。结果　肾病大鼠肾组织 PAI- 1表达均高于正常对照组 ,而 u PA、t PA均低于正常组 ;经治疗后肾组织 PA I- 1趋于下降 ,而 u PA、t PA表达趋于增高 (P<0 .0 1)。结论　纤溶系统的平衡紊乱是肾病大鼠肾小球硬化和肾间质纤维化进展中的重要病生理变化之一 ,ACEI治疗可改善 PAs/ PAI- 1的异常表达 ,防止细胞外基质的异常沉积 ,阻止肾小球硬化和间质纤维化病变进展。     

大黄酚对单侧输尿管梗阻模型大鼠肾组织CTGF、α-SMA和FN的影响

目的探讨大黄酚对大鼠单侧输尿管梗阻模型(UUO)肾间质纤维化的影响。方法 27只SD大鼠随机分为假手术组、模型组、大黄酚组。用单侧输尿管梗阻术建立肾间质纤维化模型,大黄酚治疗14 d后检测血肌酐、尿素氮水平;采用免疫组织化学方法观察肾组织结缔组织生长因子(CTGF)、α-平滑肌肌动蛋白(α-SMA)、纤维连接蛋白(FN)的表达情况。结果与假手术组相比,模型组血肌酐、尿素氮的水平以及CTGF、α-SMA、FN的表达均显著增高。与模型组相比,大黄酚组血肌酐、尿素氮水平降低,CTGF、α-SMA、FN的阳性表达显著下调。结论大黄酚可能通过抑制UUO大鼠肾组织CTGF、α-SMA、FN的表达,从而缓解肾间质纤维化的发生发展。     

褐藻多糖硫酸酯对单侧输尿管结扎大鼠肾组织NF-κB表达的影响

目的:探讨核转录因子-κB(NF-κB)在肾间质纤维化中的表达情况及褐藻多糖硫酸酯(FPS)的干预作用.方法:54只大鼠随机分为假手术组、模型组和药物组等3组,每组18只.模型组和药物组采用单侧输尿管梗阻(UUO)模型,分别于术后2,4,6周处死大鼠,观察大鼠血肌酐(Scr)、尿素氮(BUN)及肾组织HE、Masson染色观察梗阻侧肾脏大鼠的组织形态学变化,用免疫组织化学方法检测肾组织核转录因子NF-κB的表达.结果:假手术组大鼠肾组织NF-κB无表达或仅有轻度表达;与假手术组比较,模型组肾组织表现为纤维化病理改变,同时出现NF-κB强阳性表达(P<0.01),其表达量随病程延长及纤维化进展呈上升趋势;与模型组比较,药物组NF-κB表达量减少(P<0.01),血Scr和Bun含量减少,肾间质纤维化有所减轻.结论:褐藻多糖硫酸酯可能通过调节NF-κB表达而减缓肾纤维化病程进展.     

金雀异黄素对肾小管间质纤维化模型大鼠肾组织DDR1、bFGF表达的影响

目的 探讨DDR1在肾小管损伤及间质纤维化过程中的表达以及金雀异黄素在肾小管损伤及间质纤维化过程中对肾脏的保护作用及可能机制.方法 采用单侧输尿管结扎致肾间质纤维化大鼠模型,将45只大鼠随机分为三组:假手术组、模型组、金雀异黄素干预组,分别于术后7d、14d、21d每组各处死5只大鼠,收集血清测定尿素氮(BUN)、血肌酐(Scr)水平,结扎侧肾组织行HE染色观察肾脏病理变化,Masson染色分析肾间质纤维化程度,免疫组化半定量检测各组大鼠肾组织DDR1、bFGF的表达.结果 模型组DDR1、bFGF表达及肾间质纤维化程度明显高于假手术组,BUN、Scr水平显著升高(P＜0.01);金雀异黄素干预组DDR1、bFGF表达及肾间质纤维化程度较模型组明显降低(P如.01或0.05),部分时间段BUN、Scr水平有所下降(P＜0.05).结论 金雀异黄素可能通过降低DDR1及bFGF的表达而减轻肾小管损伤及间质纤维化程度.     

残肾大鼠血小板反应蛋白表达与肾组织纤溶状态的关系

目的　研究 7/ 8肾切除慢性肾衰大鼠肾小管间质病变过程中血小板反应蛋白 (TSP) 1与尿激酶型纤溶酶原激活物 (uPA)蛋白表达在调节纤溶系统功能中的意义。方法　以 7/ 8肾切除SD大鼠为实验动物模型 ,予水蛭和ACEI 洛汀新治疗 12周后杀检残肾常规病理改变 (PAS染色 )。免疫组织化学染色观察残肾组织TSP 1与uPA蛋白表达变化 ,并比较二者表达的相关性及TSP 1与间质纤维化病变的相关性。结果　 7/ 8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 ,临床上表现为慢性肾功能衰竭。给予治疗后肾功能明显改善 ,残肾组织病理改变好转。免疫组化提示肾小管间质区TSP 1、uPA蛋白表达上调 ,且二者表达在时相和定位上呈正相关 ,而TSP 1表达与间质纤维化程度则呈负相关。结论　本研究提示在慢性肾衰大鼠间质病变经治疗恢复过程中uPA与TSP 1的表达具有促纤溶作用     

卡托普利和氯沙坦对自发性高血压大鼠纤溶功能的影响

目的:观察卡托普利和氯沙坦对自发性高血压大鼠(SHR)纤溶酶原激活物抑制剂-1(PAI-1)和组织型纤溶酶原激活物(t-PA)血浆活性及组织表达的影响。方法:SHR分为卡托普利组、氯沙坦组和对照组,用发色底物法测血浆PAI-1和t-PA活性,RT-PCR半定量法测组织表达。结果:SHR主动脉组织PAI-1表达增加,卡托普利(P<0.01)和氯沙坦(P<0.05)使PAI-1表达显著降低。结论:转换酶抑制剂卡托普利和血管紧张素II受体1拮抗剂氯沙坦可减少早期SHR主动脉PAI-1表达,改善局部的纤溶平衡和血管重构。     

依那普利及大黄素对人肾成纤维细胞的影响

目的 观察大黄素、依那普利对人肾成纤维细胞产生纤维连接蛋白(FN)和纤溶酶原激活物抑制剂(PAI-1)的影响。方法 利用原代培养的人肾成纤维细胞。FN含量和PAI-1活性分别采用ELISA法和发色底物法。结果 依那普利及不同浓度的大黄素可以抑制血管紧张素(Ang)Ⅱ诱导的肾成纤维细胞分泌FN和PAI-1活性增高。结论 依那普利及大黄素可能通过抑制PAI-1活性,增加FN降解,从而在防治肾间质纤维化中起一定的作用。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.