对接触系统的再认识

目前人们已认识到接触系统在启动体内凝血方面所起的作用微乎其微，而接触系统蛋白的缺乏却可能是血栓形成的危险因素。研究表明活化的因子Ⅻ(FⅫa)和活化的因子Ⅺ(FⅪa)可裂解纤溶酶原；激肽释放酶能将前尿激酶活化为双链结构的尿激酶；高分子量激肽原和低分子量激肽原能选择性抑制凝血酶诱导的血小板活化；高分子量激肽原可通过置换粘附蛋白抑制细胞粘附，可通过抑制内皮细胞的迁移和增殖抑制血管新生；内毒素可激活接触系统，高分子量激肽原的下降和α2巨球蛋白．激肽释放酶复合物的上升与不可逆低血压的发生显著相关。总之，接触系统在促进纤维蛋白溶解、抗血栓、抗粘附、抑制新生血管形成、介导炎症反应等病理生理方面起着重要作用。     

Inhibition of T-cell activation with HLA-DR1/DR4 restricted Non-T-cell stimulating peptides

It has been reported that collagen II (CII) derived peptide CII263-272 induced T-cell activation via its amino acids responsible for T-cell receptor (TCR) recognition. The impact of substitution of the TCR contacting amino acids of CII263-272 on T-cell activation was evaluated in this study using a panel of altered CII263-272 peptides. Computer modeling revealed that the side chains of 263F and 266E in CII263-272 were coupled with amino acids on alpha1 and beta1 chains of HLA-DR1 or -DR4, mainly via hydrogen bonds, whereas the side chains of 267Q and 270K protrude out of the cleft and might be recognized by TCR. Intracellular delivery of the altered peptides, and their binding to HLA-DR1 and -DR4 molecules on cell surface, were demonstrated by confocal microscopy and flow cytometry. The results also revealed that the substitution of 267Q, 268G, 269P, and 270K individually or consecutively by alanine (A) or glycine (G) led to weak or non-T-cell responses. Furthermore, the altered peptides with 270K substitution (270A) or with consecutive substitution of 268G, 269P, and 270K (sub268-270) dramatically inhibited T-cell activation. It is suggested that the altered peptides derived from CII263-272 with substitution of amino acids responsible for TCR contact might be of inhibitory effect on T-cell responses.     

前列腺癌病理诊断中的若干概念性、技术性和经验性问题

近10年来随着我国前列腺癌穿刺活检和切除标本量的迅速增加,国内病理学者对前列腺癌的诊断水平快速提高.早期在穿刺活检中将误穿的精囊腺组织、尿道球腺组织和神经节细胞误诊为前列腺癌的低级错误现在已很少发生,前列腺癌的形态学诊断指标、腺癌的各种组织学变异、Gleason分级标准也已经逐渐普及.但由于我国在这一领域起步较晚,地区和医院间发展不平衡,我们在日常会诊中还是经常发现一些带有共性的问题,这些错误有的是概念性,有的是经验性,也有的是在诊断前的标本处理上就存在缺陷.我们将目前前列腺癌病理诊断中的常见误区归纳为以下几点,供大家在日常工作中参考.     

Association of genetic polymorphisms and haplotypes in hMLH1 and hMSH3 gene with the risk of papillary thyroid carcinoma

OBJECTIVE: To explore the relationship of the genetic polymorphisms and the haplotypes in hMLH1 and hMSH3 gene with the risk of papillary thyroid carcinoma (PTC) in Chinese Hans. METHODS: A hospital based 1:1 matched case-control study was carried out. The polymorphisms for 204 pairs of PTC cases and healthy controls were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele specific oligonucleotide (PCR-ASO) assays. RESULTS: (1) The PTC risk was marginally increased in the hMLH1 1151TA genotype, with odds ratio (OR) of 2.15 (95%CI: 0.99-4.85); the PTC risk was significantly increased in the mutant genotype 1151TA+AA, with OR of 2.15 (95%CI: 1.02-4.69); (2) The haplotypes of -93G, 1151A, 655A in the hMLH1 gene could increase the PTC risk, with OR of 2.67 (95%CI: 1.16-6.53, P=0.011), compared with the haplotype of -93G, 1151T, 655A; (3) Compared to 3124A, 2835G haplotype in hMSH3 gene, the 3124G, 2835A haplotype could increase the PTC risk marginally, with OR of 3.08 (95%CI: 0.92-13.25). CONCLUSION: The 1151T/A polymorphism in hMLH1 was associated with PTC; both the haplotype of -93G, 1151A, 655A in hMLH1 and the 3124G, 2835A haplotype in hMSH3 were associated with PTC.     

长程体外反搏对高胆固醇血症猪高级氧化蛋白产物和高敏C反应蛋白的影响

目的探讨长程体外反搏对高胆固醇血症猪血清中高级氧化蛋白产物(AOPP)和高敏C反应蛋白(hs-CRP)的影响.方法 18头雄性乳猪随机分为正常饲养组(n=6)、高脂饲养组(n=6)及高脂饲养+体外反搏组(n=6).后2组通过高脂饲养复制高胆固醇血症猪模型并对高脂饲养+体外反搏组进行36 d共36 h的长程增强型体外反搏.分别于分组饲养前、反搏前、反搏中期和反搏结束时留取3组动物静脉血,采用分光光度法检测血清AOPP浓度,采用乳胶凝集反应法检测血清hs-CRP浓度.结果高脂饲养组和高脂饲养+体外反搏组经高脂饲养后血清总胆固醇和低密度脂蛋白明显升高(P<0.05).血清AOPP和hs-CRP浓度在分组饲养前组差异无统计学意义(P>0.05).反搏前、反搏中期和反搏结束时,高脂饲养组与高脂饲养+体外反搏组血清AOPP和hs-CRP浓度较正常饲养组同时期均有显著增高(P<0.05);而反搏中期和反搏结束时高脂饲养+体外反搏组血清AOPP浓度较高脂饲养组显著降低[(95.38±12.66)μmol/L比(128.46±12.55)μmol/L;(85.78±10.33)μmol/L比(158.22±16.32)μmoL/L,P<0.05];且反搏中期和反搏结束时高脂饲养+体外反搏组血清hs-CRP浓度较高脂饲养组也有显著降低[(0.47±0.14)mg/L比(0.62±0.32)mg/L;(0.47±0.16)mg/L比(0.59±0.43)mg/L,P<0.05].结论 AOPP和hs-CRP参与了高胆固醇血症猪的发病过程.长程体外反搏可能通过减轻机体体内氧化应激和微炎性反应过程,从而阻止高胆固醇血症的病理生理进程.     

磷酸钙人工骨(CPC)在颈前路椎间融合的临床应用

目的探讨磷酸钙人工骨(CPC)在颈椎前路椎间融合手术中的应用效果。方法2001年4月至2003年10月颈前路手术中应用磷酸钙人工骨栓椎间融合结合钛钢板固定治疗颈椎病17例,颈椎间盘突出症5例,颈椎外伤脱位2例,共24例35个节段。采用JOA评分评价神经功能,X线片判定融合效果。结果随访18±6.5个月,术后无感染,无过敏或毒性反应。JOA评分由术前9.28±2.15分增加到14.65±2.18分(P<0.001)。术后X线片未见CPC骨栓塌陷或移位,钛板和螺钉无松动及折断。术后16.5±6.8个月均获得椎间融合。结论颈椎前路椎间融合手术应用磷酸钙人工骨替代自体骨,经济、安全、简便、效果可靠。     

槲皮素对TGF-β1诱导的大鼠肾小管上皮细胞细胞外基质积聚的影响

目的：观察转化生长因子（TGF）-β₁对大鼠肾小管上皮细胞MCP-1、PAI-1和Col-Ⅰ表达的影响，并探讨槲皮素的作用。方法:以大鼠肾小管上皮细胞（NRK-52E）为研究对象，采用TGF-β₁(10 μg/L)刺激，部分实验中培养的细胞在刺激前用槲皮素(50 μmol/L)预处理90 min。MCP-1及COL-Ⅰ mRNA的表达采用RT-PCR检测。PAI-1mRNA和蛋白的表达分别采用RT-PCR和Western blotting 法检测。结果:NRK-52E 细胞在TGF-β₁刺激后MCP-1 mRNA显著上调，在2 h开始升高，8 h达高峰，呈时间依赖性；PAI-1 mRNA和蛋白的表达也显著增加；同时，TGF-β₁还显著上调Col-ⅠmRNA的表达，24 h为正常的2.4倍（P<0.05）。槲皮素预处理后，TGF-β₁诱导的MCP-1、PAI-1和Col-Ⅰ的上调表达均受到明显抑制（P<0.05）。结论:槲皮素能够通过抑制MCP-1、PAI-1和Col-Ⅰ的表达而部分逆转TGF-β₁诱导的肾小管上皮细胞细胞外基质的积聚，这可能有利于延缓肾间质纤维化的发生和发展。     

IL-15 and IL-15Rα gene deletion: Effects on T lymphocyte trafficking and the microglial and neuronal responses to facial nerve axotomy

IL-15 is a potent T cell chemoattractant, and this cytokine and its unique α subunits, IL-15Rα, can modify immune cell expression of several T cell chemokines and their receptors. Facial nerve axotomy in mice leads to T cell migration across an intact blood–brain-barrier (BBB), and under certain conditions T cells can provide neuroprotection to injured neurons in the facial motor nucleus (FMN). Although chemokines and chemoattractant cytokines are thought to be responsible for T cell migration to the injured cell bodies, data addressing this question are lacking. This study tested the hypothesis that T cell homing to the axotomized FMN would be impaired in knockout (KO) mice with the IL-15 and IL-15Rα genes deleted, and sought to determine if microglial responsiveness and motoneuron death are affected. Both IL-15KO and IL-15RαKO mice exhibited a marked reduction in CD3⁺ T cells and had fewer MHC2⁺ activated microglia in the injured FMN than their respective WT controls at day 14 post-axotomy. Although there was a relative absence of T cell recruitment into the axotomized FMN in both knockout strains, IL-15RαKO mice had five times more motoneuron death (characterized by perineuronal microglial clusters engulfing dead motoneurons) than their WT controls, whereas dead neurons in IL-15KO did not differ from their WT controls. Further studies are needed to dissect the mechanisms that underlie these observations (e.g., central vs. peripheral immune contributions).     

糖尿病小鼠胸主动脉环对血管收缩剂和内皮依赖性舒张剂反应的变化

目的：探讨糖尿病（DM）小鼠在不同时期离体胸主动脉环对血管收缩剂和内皮依赖性舒张剂反应的变化。 方法： 用腹腔注射链脲佐菌素（STZ）40 mg/kg诱导C57BL/6J小鼠产生糖尿病，在17、22和28周分批处死糖尿病和同年龄对照（control）组小鼠，测定其离体胸主动脉环对血管收缩剂：苯肾上腺素（PE）、60 mmol/L KCl的反应及对内皮依赖性舒张剂乙酰胆碱（ACh）的反应。 结果： DM组小鼠2周后空腹血糖≥11.1 mol/L并在整个实验过程中维持这一水平，显著高于control组，而体重显著低于control组；17、22和28周DM组胸主动脉环对PE的反应性分别高于、接近、高于control组，各时期对60 mmol/L KCl都表现高于control组；17、22和28周DM组胸主动脉环对ACh的反应性分别高于、接近、低于control组。 结论： DM组小鼠胸主动脉环对血管收缩剂的反应增强，而内皮功能先代偿性增强，然后降低，表现为内皮损伤。     

An animal model of SARS produced by infection of Macaca mulatta with SARS coronavirus

A new SARS animal model was established by inoculating SARS coronavirus (SARS-CoV) into rhesus macaques (Macaca mulatta) through the nasal cavity. Pathological pulmonary changes were successively detected on days 5-60 after virus inoculation. All eight animals showed a transient fever 2-3 days after inoculation. Immunological, molecular biological, and pathological studies support the establishment of this SARS animal model. Firstly, SARS-CoV-specific IgGs were detected in the sera of macaques from 11 to 60 days after inoculation. Secondly, SARS-CoV RNA could be detected in pharyngeal swab samples using nested RT-PCR in all infected animals from 5 days after virus inoculation. Finally, histopathological changes of interstitial pneumonia were found in the lungs during the 60 days after viral inoculation: these changes were less marked at later time points, indicating that an active healing process together with resolution of an acute inflammatory response was taking place in these animals. This animal model should provide insight into the mechanisms of SARS-CoV-related pulmonary disease and greatly facilitate the development of vaccines and therapeutics against SARS.