柴苓调肝颗粒对非酒精性脂肪性肝病大鼠肝组织肿瘤坏死因子-α及瘦素基因表达的影响

目的:通过实验研究观察柴苓调肝颗粒对非酒精性脂肪性肝病(NAFLD)大鼠肝组织肿瘤坏死因子(TNF)-α、瘦素(LP)基因表达的影响,探讨其治疗作用机制。方法:以喂高脂饲料的方法制备大鼠NAFLD模型,造模成功后,随机分为8组,柴苓调肝颗粒高、中、低剂量组,甘乐对照组、三七脂肝丸对照组、模型对照组、饮食控制组和正常对照组。观察实验大鼠治疗前后一般状态及病理改变;采用免疫组化二步法检测肝组织中的TNF-α,CYP2E1蛋白的表达;实时荧光定量聚合酶链反应(Real Time-PCR,RT-PCR)法检测肝组织中的TNF-αmRNA和LPmRNA表达水平。结果:柴苓调肝颗粒高剂量组大鼠各项指标与模型对照组和饮食控制组比较差异均有显著性意义(P<0.05或P<0.01),与正常对照组比较差异无统计学意义(P﹥0.05)。结论:柴苓调肝颗粒可以减轻大鼠体重,降低肝组织中TNF-α、CYP2E1含量及蛋白表达量,降低肝组织中的TNF-α和LP mRNA表达水平,使肝组织病理学改变减轻并且趋于正常。其作用机制可能与柴苓调肝颗粒能够调节脂代谢相关的TNF-α和LP有关。     

柴苓调肝颗粒剂治疗大鼠非酒精性脂肪性肝病的实验研究

[目的]探讨柴苓调肝颗粒剂治疗大鼠非酒精性脂肪性肝病(NAFLD)的作用机制。[方法]采用高脂饲料的方法制备大鼠NAFLD模型,造模成功后,随机分为7组,柴苓调肝颗粒剂高、中、低剂量(高、中、低剂量)组,甘乐对照(甘乐)组、三七脂肝丸对照(三七脂肝丸)组、模型对照(模型)组和饮食控制组,另设正常对照(正常)组未予造模。各组分别给予相应的处理,4周后检测各组血清丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)、总胆固醇(TC)、三酰甘油(TG)、肿瘤坏死因子α(TNF-α)和瘦素(LP)以及肝组织中超氧化物歧化酶(SOD)、丙二醛(MDA)、体重及肝重指数的变化。[结果]高剂量组各项指标与模型组和饮食控制组比较差异均有统计学意义(P0.05,0.01),与正常组比较(P0.05)。[结论]柴苓调肝颗粒剂可有效治疗实验性NAFLD。     

高脂饮食诱导幼龄大鼠肝脂肪性变和胰岛素抵抗的发生及二甲双胍的干预作用

目的 通过高脂饮食诱导幼龄大鼠建立非酒精性脂肪性肝病（NAFLD）伴胰岛素抵抗模型,探讨NAFLD幼鼠胰岛素抵抗的发生机制及二甲双胍的干预疗效.方法 将60只3周龄刚离乳雄性SD大鼠按随机数字表法分为3组：对照组、高脂组及二甲双胍组（高脂＋二甲双胍）,每组各20只.对照组予普通饮食,高脂组和二甲双胍组给予高脂饮食5周,同时对照组和高脂组给予生理盐水灌胃,二甲双胍组给予二甲双胍混悬液灌胃（0.25 g·kg-1·d-1）.第5周末从各组大鼠中随机选取12只进行正常血糖-高胰岛素钳夹试验,评价胰岛素敏感性;另8只大鼠处死并取新鲜肝组织进行肝组织病理形态和脂质沉积观察,其中随机取6只通过实时荧光定量PCR分析肝组织中固醇调节元件结合蛋白-1（SREBP-1）、胰岛素受体（IR）、胰岛素样生长因子-1（IGF-1）mRNA的表达.组织学分级差异比较采用秩和检验进行分析.其他指标采用单因素ANOVA分析,两两比较采用LSD法.结果 实验5周后：（1）体重：对照组[（316±17）g]、高脂组[（202±21）g]、二甲双胍组[（171±19）g],3组间两两比较差异有统计学意义（P＜0.01）.（2）病理结果：高脂组大鼠肝脏符合典型的NAFLD病理特征.（3）葡萄糖输注率高脂组、对照组、二甲双胍组分别为（6.51±1.52）、（11.57±1.97）、（13.08±2.33）mg·kg-1·min-1.（4）与对照组相比,高脂组肝组织SREBP-1 mRNA表达较高[0.85±0.10比1.67±0.28,P＜0.05],IR mRNA[（1.16±0.22）比（0.56±0.22）,P＜0.01]、IGF-1 mRNA[（0.87±0.14）比（0.26±0.14）,P＜0.01]表达较低;高脂组与二甲双胍组肝组织SREBP-1 mRNA、IR mRNA、IGF-1 mRNA比较差异无统计学意义（P＞0.05）.结论 高脂饲养5周可建立幼龄SD大鼠NAFLD并发胰岛素抵抗模型,二甲双胍预防可提高机体胰岛素敏感性,其减少NAFLD幼鼠体重的作用与幼鼠体重是否超标可能无关.     

高脂饮食非酒精性脂肪性肝病大鼠肝脏成脂相关基因表达增强

目的探讨非酒精性脂肪性肝病（NAFLD）大鼠肝脏成脂相关基因mRNA表达的动态变化.方法模型组SD大鼠给予高脂饮食饲养,分批于实验第4、8、12、16、24周处死,同期设普通饮食饲养大鼠作对照.RT-PCR分别检测肝脏固醇调节元件结合蛋白1c（SREBP-1c）及其靶基因脂肪酸合成酶（FAS）、脂联素、抵抗素mRNA表达.结果模型组大鼠4周肝脏可见散在性肝细胞脂肪变性,8周为单纯性脂肪性肝炎,12～24周从脂肪性肝炎进展为脂肪性肝炎伴肝纤维化.从实验第4周起,模型组大鼠肝脏SREBP-1c和FAS mRNA表达逐渐增强,至24周时分别较对照组升高5～6倍和2～2.5倍;模型组大鼠肝脏从第12周起出现脂联素和抵抗素mRNA表达,两者表达量均随造模时间延长而增强.相关分析显示,SREBP-1c、FAS、脂联素、抵抗素mRNA表达量均与肝脂肪变程度呈正相关（r值分别为0.808、0.834、0.592、0.577,P值均＜0.01）.结论高脂饮食NAFLD大鼠肝脏SREBP-1c、FAS、脂联素、抵抗素等成脂基因表达增强,提示脂肪变性的肝细胞可能部分具有脂肪细胞的特征,即发生了成脂性改变.     

非酒精性脂肪性肝病患者肝脏固醇调节元件结合蛋白-1c的表达及其意义

目的 研究非酒精性脂肪性肝病(NAFLD)患者肝组织因醇凋节元件结合蛋白-1c(SREBP-1c)的表达变化,探讨其在NAFLD中的作用. 方法对临床与病理确诊的NAFLD患者,检测肝组织SREBP-1c蛋白质和mRNA的表达变化及脂肪酸合成酶的表达,并对相应的临床资料进行分析. 结果 NAFLD患者肝脂肪变程度与血清甘油三酯和胆固醇含量呈明显正相关(r值分别为0.71和0.70,P值均<0.05);NAFLD患者肝SREBP-1c表达在蛋白质和mRNA水平都明显增强,分别为2.19±0.31和0.69±0.02,高于对照组的1.15±0.20和0.40±0.02(t值分别为11.06和-14.63,P值均<0.05),且其表达强度随脂变程度的加重,由1.47±0.08和0.67±0.08增加至2.82±0.78和0.85±0.04(F=24.54,P<0.01),而与是否合并糖尿病无关; NAFLD患者肝脂肪酸合成酶表达增加,脂肪酸合成增加. 结论肝细胞SREBP-1c表达增加,导致脂肪酸合成酶蛋白增加,脂肪合成增加是NAFLD患者肝脂肪蓄积的原因之一.     

六味地黄汤对非酒精性脂肪性肝病大鼠SREBP-1c和LXR-α基因表达的影响

[目的]探讨六味地黄汤对非酒精性脂肪性肝病大鼠固醇调节元件结合蛋白(SREBP-1c)和肝X受体(LXR-α)的影响.[方法]选择雄性SD大鼠,随机分3组:正常组,六味地黄汤组(治疗组)和模型组.正常组喂养普通饲料,模型组和治疗组喂养高脂饲料建立非酒精性脂肪性肝病模型,治疗组并用六味地黄汤干预治疗;荧光定量RT-PCR检测各组大鼠SREBP-1c和LXR-α的基因表达.[结果]模型组大鼠SREBP- 1cmRNA和LXRαmRNA的相对表达均高于正常组(分别为t=2.361,P＜0.05和t=3.118,P＜0.01);与模型组相比,治疗组能显著降低SREBP-1cmRNA和LXR-αmRNA的表达(分别为t=3.816,P＜0.01和t=3.36,P＜0.01).[结论]六味地黄汤能降低SREBP-1c和LXR-α的基因表达,改善脂质代谢.     

生芪降糖颗粒对2型糖尿病大鼠血糖、血脂及血管内皮素表达的影响

目的 探讨生芪降糖颗粒对糖尿病大鼠血糖、血脂及血管内皮素表达的影响.方法 制作2型糖尿病大鼠模型,随机分为生芪降糖颗粒低剂量组、中剂量组、高剂量组、文迪雅组、对照组.正常组给予蒸馏水灌胃,模型组分别给予生芪降糖颗粒低剂量、中剂量、高剂量、文迪雅、蒸馏水灌胃,至血糖下降至正常组水平或与造模时比较有统计学差异为治疗有效.测定各组血糖、总胆固醇(TC)、甘油三酯(TG)、胰岛素、主动脉内皮素1(ET-1)的变化及ET-1mRNA表达.结果 药物干预后生芪降糖颗粒中、高剂量组和文迪雅组血糖、TC、TG和胰岛素明显下降(P均<0.01).文迪雅组和生芪降糖颗粒高剂量组ET-1和主动脉El-1mRNA表达量较对照组均显著下降(P均<0.01).结论 ①生芪降糖颗粒有抗糖尿病作用,并呈剂量依赖性;②生芪降糖颗粒降低ET-1mRNA的表达,可保护和改善糖尿病大鼠主动脉内皮和心肌的功能.     

胰岛素抵抗大鼠肝脏SREBP-1c mRNA表达及罗格列酮的干预作用

目的 探讨固醇调控元件结合蛋白-1c（SREBP-1c）在胰岛素抵抗（IR）发病中的作用及罗格列酮（RSG）的干预机制.方法 将27只大鼠适应性喂养1周后随机分为对照组、模型组及观察组各9只,模型组及观察组均予高脂饲料喂养8周建立IR模型,对照组予普通饲料喂养8周;其后观察组予RSG 3 mg/（kg·d）＋生理盐水至2 ml灌胃,模型组和对照组均予2 ml生理盐水灌胃.三组均同前喂养6周后取静脉血测定空腹胰岛素、空腹血糖、TG、游离脂肪酸（FFA）、TNF-α、瘦素,计算胰岛素敏感指数（ISI）;处死动物后测定体脂比,取肝脏组织采用RT-PCR法检测SREBP-1c mRNA表达.同时对相关指标进行Pearson相关分析.结果 SREBP-1c mRNA表达水平观察组为0.75±0.06、模型组为0.92±0.05、对照组为0.72±0.03,观察组及对照组均显著低于模型组,P均〈0.01.Pearson相关分析显示,SREBP-1c mRNA与TG（r=0.802,P〈0.01）、FFA（r=0.666,P〈0.01）、TNF-α（r=0.749,P〈0.01）、瘦素（r=0.708,P〈0.01）、体脂比（r=0.495,P〈0.01）均呈明显正相关,与ISI（r=-0.677,P〈0.01）呈负相关.结论 SREBP-1c mRNA过表达与IR发生有关,RSG可能通过降低SREBP-1c mRNA表达改善IR和脂代谢紊乱;此为IR及相关疾病的治疗提供了新的靶点.     

肝SOCS-3和SREBP—1c基因表达在大鼠胰岛素抵抗及非酒精性脂肪肝中的作用

目的探讨胰岛素抵抗（IR）和非酒精性脂肪肝（NAFL）联系的可能分子机制。方法用高脂喂养建立NAFL大鼠模型,对部分大鼠限食干预,RT-PCR检测肝脏细胞因子信号抑制物3（SOCS-3）及固醇调节成分结合蛋白1c（SREBP-1c）的表达,并观察肝脏病理改变。结果与正常对照组比,高脂组TC、TG、HOMA-IR水平升高（P〈0．01）,肝脏SOCS-3、SREBP-1cmRNA表达增加（P〈0．05）,高脂限食组相关指标下降。结论IR和NAFL可通过一系列因子相互联系。饮食对大鼠IR和NAFL有一定的影响。     

早期胰岛素治疗对糖尿病大鼠骨骼肌细胞胆固醇调节元件结合蛋白-1c表达的影响

目的 探讨早期胰岛素治疗对糖尿病大鼠骨骼肌细胞内胆固醇调节元件结合蛋白-1c(SREBP-1c)表达的影响及可能的分子机制.方法 将7～8周龄高脂喂养联合小剂量链脲佐菌素诱导的雄性糖尿病SD大鼠24只按随机数字表法分为4组:正常对照组、未治疗糖尿病组、胰岛素组、格列齐特组,每组各6只.通过real-time PCR和Western blot法检测骨骼肌细胞SREBP-1c mRNA和核内成熟型蛋白表达水平、肿瘤坏死因子-α(TNF-α)蛋白表达、信号转导及转录活化子3磷酸化(Tyr705)(p-STAT3)蛋白表达水平.结果 与对照组(3.7±1.1)比较,糖尿病大鼠骨骼肌细胞SREBP-1c mRNA(7.3±2.6)和核内蛋白(3.3±0.4)、TNF-α(0.44±0.03)及P-STAT3蛋白(0.50 ±0.08)表达水平显著上调,早期胰岛素治疗则下调了SREBP-1c mRNA(4.1±1.8)和核内蛋白(2.7±0.3)表达、TNF-α(0.19±0.22)及P-STAT3蛋白(0.29±0.03)表达,差异有统计学意义(P<0.05).结论 早期胰岛素治疗抑制骨骼肌细胞内脂质合成通路中关键转录分子的表达,可能是骨骼肌内脂质沉积减少的机制之一.     

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.     

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.     

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.     

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.