Effect of dipyridamole with or without aspirin on urine protein excretion in patients with membranous glomerulonephritis

Summary The antiproteinuric effect of the antiplatelet agent dipyridamole has been assessed after inhibiton of thromboxane B₂ (TxB₂) synthesis in 8 patients with confirmed membranous glomerulonephritis. There were three study periods, each of 30 days, and 45 days apart, namely a washout period, treatment with dipyridamole 300 mg/d, and dipyridamole 225 mg/d plus aspirin 150 mg/d. On Days 1 and 30 of each study period serum and urine creatinine, 24-h excretion of protein, creatinine clearance, platelet aggregometry on whole blood and serum TxB₂ were measured. Treatment with dipyridamole alone or with aspirin produced significant inhibition of platelet aggregation and a fall in 24-h protein excretion; the latter amounted to 54% with dipyridamole alone and 56 % with dipyridamole plus aspirin (NS). Dipyridamole plus aspirin caused an 82 % reduction in serum TxB₂.     

高血压病患者血清瘦素含量与胰岛素抵抗水平的相关性研究

目的：探讨高血压病患者血清瘦素水平与胰岛素抵抗的关系。方法：测定217例高血压病患者(男92例，女125例)的空腹血清瘦素含量、空腹血糖、胰岛素、收缩压、舒张压和体质量指数(BMI)，稳态模式评估法计算胰岛素抵抗指数(HOMA-IR)。分析瘦素与其他各项参数的相关性。结果：以HOMA—IR的25％位点，作为判断胰岛素抵抗的切割点，把高血压病患者分为胰岛素抵抗组(IR)和胰岛素敏感组(IS)，血清瘦素浓度IR组显著高于IS组(P＜0．05)。血清瘦素浓度与HOMA—IR呈显著正相关(男性r＝0．407，P＜0．01；女性r＝0．254，P＜0．01)；校正年龄和BMI后，男性组两者仍呈显著正相关(r＝0．219，P＜0．05)，女性组两者无相关；逐步回归分析显示，男性组HOMA—IR为血清瘦素浓度的独立预测因素。结论：男性高血压病患者血清瘦素浓度与胰岛素抵抗直接相关，女性则无直接相关性。性别差异的机制有待进一步探讨。     

Porins and lipopolysaccharide stimulate platelet activating factor synthesis by human mesangial cells.

Porins, a family of hydrophobic proteins located in the outer membrane of the cell wall of gram-negative bacteria and lipopolysaccharide (LPS), were shown to stimulate the synthesis of platelet activating factor (PAF), a phospholipid mediator of inflammation and endotoxic shock, by cultured human glomerular mesangial cells (MC). The synthesis of PAF induced by porins was rapid (peak at 20 min) and independent either from contamination by LPS or from generation of an endotoxin-induced cytokine such as tumor necrosis factor (TNF) since it was not prevented by cycloheximide, an inhibitor of protein synthesis or anti-TNF blocking antibodies. LPS also stimulated PAF synthesis by MC. However, the kinetic of PAF synthesis induced by LPS was biphasic with an early and transient peak at 10 minutes and a second and sustained peak at three to six hours. This second peak required an intact protein synthesis and was prevented by anti-TNF antibodies, suggesting the dependency on LPS-induced synthesis of TNF. Experiments with labeled precursors demonstrated that in MC, either after stimulation with porins or LPS, PAF was synthesized via the remodeling pathway that involves acetylation of 1-0-alkyl-sn-glyceryl-3-phosphorylcholine (2-lyso-PAF) generated from 1-0-alkyl-2-acyl-sn-glyceryl-3-phosphorylcholine by phospholipase A2 (PLA2) activity. Porins and LPS, indeed, induced PLA2-dependent mobilization of [14C]-arachidonic acid that was inhibited by p-bromodiphenacylbromide (PBDB). PBDB, an inhibitor of PLA2, also blocked PAF synthesis by preventing the mobilization of 2-lyso-PAF, the substrate for PAF-specific acetyltransferase.(ABSTRACT TRUNCATED AT 250 WORDS)     

白细胞介素-13功能研究进展

白细胞介素－13主要由活化的Th2(CD4^ )细胞分泌，诱导单核巨噬细胞分化及延长寿命；促进MHC－Ⅱ，CD23表达；抑制炎性和趋化因子产生；诱导B细胞增殖，活化，刺激IgM,IgG的产生和重链的转换；使血管细胞粘附分子－1表达；抑制人类免疫缺陷病毒（HIV）复制；间接诱导巨噬细胞和NK细胞参与抗肿瘤作用。在变态反应性疾病和哮喘中引起呼吸道高反应性，嗜酸粒细胞性炎症，粘液分泌过多，基膜纤维化等，其受体是与IL－4Rα形成功能复合体而发挥作用。IL－13信号转导途径除了JAK／STAT6以外，尚有IRS－1,Fes，磷酸激酶，BCL－6／SOCS等途径。     

Spontaneous angina caused by spasm of the left coronary artery]

A 42 year old woman presented with a one year history of retrosternal chest pain and back pain on effort and at rest sometimes accompanied by minor syncopal attacks. Transient atrioventricular block was documented during one such episode associated with hypotension. Coronary angiography showed spontaneous spasm of the left main coronary artery with clinical symptoms but no electrocardiographic changes. The spasm was relieved by injection of SIN-1. The similarity between the previous clinical symptoms and those observed at coronary angiography was in favour of the diagnosis of spasm of the left main coronary artery without atherosclerotic coronary disease. Treatment with calcium atherosclerotic coronary disease. Treatment with calcium blockers and platelet antiaggregants led to total regression of her symptoms with a follow-up of 5 months.     

丹参及血管内皮生长因子对动物肢体缺血模型侧支循环建立的作用

目的 :建立兔左后肢无主干及分支动脉供血的缺血模型 ,并观察丹参及血管内皮生长因子 ( VEGF)对兔后肢缺血模型侧支循环建立的作用。方法 :通过手术方法在兔后肢大腿段建立一个无主干及分支动脉供血的严重缺血模型。动物随机分为 5组 :未治疗组、丹参组、VEGF组、丹参加VEGF组及生理盐水对照治疗组。在解剖及生理水平上观察各组动物缺血肢体缺血及侧支循环建立情况。结果 :术后第 1天未治疗组动物左 /右小腿血压比为 0 ;动脉造影显示左侧只有髂外动脉中段以上显影、以下主干及分支均未显影。对侧后肢主干及分支动脉显影良好 ,即左侧毛细血管密度( 4 9.8± 1 7.6)个 /mm2 ,右侧为 ( 385 .7± 36.7)个 /mm2 ,P<0 .0 0 1 ;毛细血管数 /肌束数比值 :左侧( 0 .2 1± 0 .0 7) ,右侧 ( 0 .98± 0 .0 5 ) ,P<0 .0 0 1。治疗结束时 ,丹参加 VEGF组动物小腿血压比最高( 0 .74± 0 .1 7) ,它显著高于对照组、丹参组和 VEGF组 ;毛细血管密度与毛细血管数 /肌束数比值亦以丹参加 VEGF组为最高 ;动脉造影显示 ,丹参加 VEGF组中缺血组织处具有治疗意义的粗大的侧支循环形成。结论 :丹参与 VEGF联合应用具有强大的促进缺血模型侧支循环建立的作用