尿转化生长因子-β1和细胞外基质在慢性肾小球肾病中的变化

目的：探讨尿中转化生长因子-β1（TGF-β1）和细胞外基质（ECM）在各种慢性肾小球肾病患者中的变化及其临床意义。方法：将105例慢性肾小球患者进行临床和病理分组,采用酶联免疫吸附试验（ELISA）分别检测各组的尿TGF-β1水平,同时采用放射免疫分析法（RIA）检测尿中的各种ECM,所有检测值均用尿肌酐（Cr）浓度进行校正。结果：在不同临床分组中,尿TGF-β1/Cr和LN/Cr、PCⅢ/Cr、Ⅳ-C/Cr水平明显高于对照组（P〈0.05）,尿HA/Cr水平则在Ⅲ、Ⅳ组中出现下降。而在不同的病理分组中,肾小球轻微病变（GML）组尿中TGF-β1、ECM与对照组比较无统计学意义,其他各病理分组则出现不同的变化。相关性分析尿TGF-β1/Cr与LN/Cr、PCⅢ/Cr、Ⅳ-C/Cr正相关,与HA/Cr无相关性。结论：通过尿TGF-β1和ECM在慢性肾小球肾病患者中的联合检测,对评价慢性肾小球肾病的进展和预后判断提供一定的临床价值。     

血清胱抑素C对高血压和糖尿病早期肾功能损伤的诊断价值

目的探讨血清胱抑素C(Cys-C)水平对高血压、糖尿病早期肾功能损害的临床价值。方法收集22例高血压患者、28例糖尿病患者及44例肾病患者的血清标本,用酶法测定血清肌酐、尿素氮,用颗粒增强免疫比浊法测定血清Cys-C,放射免疫法测定β2-微球蛋白。结果血清Cys-C和β2-微球蛋白的异常检出率显著高于血清肌酐、尿素氮;高血压及糖尿病两组患者血清Cys-C水平均较正常对照组明显升高(P<0.01);肾病组各项检测指标均显著高于高血压组、糖尿病组和正常对照组。结论对早期肾功能损害的诊断价值,血清Cys-C测定敏感性稍次于β2-微球蛋白,但其特异性优于血清β2-微球蛋白,综合比较,血清Cys-C可作为高血压及糖尿病早期肾功能损害的辅助诊断指标之一。     

AmpC酶在主要肠杆菌科和非发酵菌中的携带率及耐药性

目的：调查主要肠杆菌科细菌和非发酵菌产AmpC酶和ESBLs的状况及对常用抗菌药物的耐药性，指导临床合理用药。方法：常规培养分离细菌，应用VTTEK微生物自动分析仪和API鉴定系统鉴定病原菌；药敏试验采用K-B纸片扩散法；AmpC酶检测采用三维试验法；ESBLs检测采用双纸片确认试验。结果：主要肠杆菌科细菌产AmpC酶和ESBLs的阳性率分别为18．9％，52．8％，其中以大肠杆菌、肺炎克雷伯、产酸克雷伯、阴沟肠杆菌为主，同时产2种酶的菌株占15．4％；绿脓杆菌产AmpC酶和ESBLs酶的阳性率分别为18．2%，，42．0％，同时产2种酶的菌株占13．6％；不动杆菌的产酶率均在8．0％以下,产酶菌的耐药率高于非产酶菌，除绿脓杆菌外，产AmpC酶菌株的耐药率高于产ESBLs菌株．主要肠杆菌科细菌对泰能(IMP)的敏感性为99．5%，而对舒普深(CPZ)的耐药率平均为13．8％；非发酵菌对IMP，马斯平(FEP)、CPZ的耐药率平均分别为20．4％，44．3％，18．6％.结论：主要肠杆菌科细菌的产酶率高于非发酵菌，产AmpC酶的菌株已近20．0%，应引起临床的高度重视；绿脓杆菌产ES-BLs的菌株也较高，也应该加强监控．对产酶菌引起感染的治疗应根据细菌药敏试验结果，合理选择有效的抗菌药物联合治疗；对重症感染患的治疗应根据药敏试验结果重点应用泰能或舒普深治疗。     

氟伐他汀对环孢素A所致大鼠成纤维细胞肾毒性的保护作用

目的 观察免疫抑制剂环孢素Ａ（CsA）对大鼠肾脏成纤维细胞增殖及细胞因子表达的影响以及氟伐他汀的干预作用，探讨氟伐他汀对CsA肾毒性的保护作用。 方法 体外培养大鼠肾脏成纤维细胞，四甲基偶氮唑盐（MTT）比色法测定CsA及氟伐他汀对细胞增殖的影响。RT-PCR方法检测转化生长因子β1（TGF-β1）、结缔组织生长因子（CTGF）及c-fos mRNA水平。Western印迹检测纤连蛋白(FN)的表达。 结果 CsA可明显抑制成纤维细胞增殖，且呈剂量和时间依赖效应（P < 0.05）。氟伐他汀与CsA合用后，对细胞增殖有明显的抑制作用（P < 0.01）。CsA刺激成纤维细胞TGF-β1、CTGF、c-fos及FN的产生（P < 0.05），氟伐他汀可下调这些改变（P < 0.05）。 结论 氟伐他汀可减轻CsA所致的大鼠肾脏成纤维细胞毒性     

盐酸氯胺酮-β-环糊精包合物的研究

采用正交设计法对饱和水溶液法制备盐酸氯胺酮－β－环糊精包合物的温度、时间及投料比进行选优，显微观察包合物形态，UV和X－射线衍射法测试包合物晶形变化，品尝包合物味觉效果，并测定其稳定性及溶出度。结果表明，按1：2主客克分子比，于25℃电动搅拌3h，制备包合物的包合率和收率较高，包合物已形成一种新物相，具有稳定性高，无苦味及缓释性能。     

The intra-cortical trajectory of the coeruleo-cortical projection in the rat: A tangentially organized cortical afferent

Cortical and sub-cortical lesions in the rat were used to analyze the intracortical trajectory of the noradrenergic axons, which were visualized by aldehyde-induced catecholamine histofluorescence and by immunohistochemistry using an antibody directed against rat dopamine-β-hydroxylase. Following subcortical lesions there is a slowly progressive reduction in the density of cortical noradrenergic axons, indicating that they undergo asynchronous anterograde degeneration. By 2 weeks after transection of the dorsal noradrenergic bundle, no dopamine β-hydroxylase-immunoreactive fibers are detectable in the ipsilateral cortex. Neither transection of the cingulum bundle, nor parasagittal incisions through the dorsal cortex lateral to the cingulum, diminished the noradrenergic innervation of medial or dorso-lateral cortex. A cortical lesion medial to the cingulum bundle markedly reduced the density of noradrenergic fibers in cingulate cortex caudal to the lesion, but did not affect the innervation of dorso-lateral cortex. In contrast, dorso-lateral frontal incisions and decortication (frontal lobotomy) produced a marked ipsilateral decrease in the noradrenergic fiber density throughout the remaining dorso-lateral cortex, while sparing the innervation of cingulate and infra-rhinal cortex.These results demonstrate that the dorso-lateral cortex is innervated by noradrenergic fibers in the medial forebrain bundle that reach the frontal pole, turn dorsally over the anterior portion of the forceps minor and continue caudally within the deep layers of frontal and dorso-lateral cortex, supplying the noradrenergic innervation throughout their trajectory. The medial cortex is innervated by a separate group of noradrenergic fibers that ascend through the septum, curve over the genu of the corpus callosum, and run caudally in the supracallosal stria.The present results show that the cingulum bundle is not a major intra-cortical noradrenergic pathway and does not provide branches that contribute significantly to the innervation of dorsal or lateral cortex. Thus the medial and lateral cortex can be selectively and differentially denervated of noradrenergic fibers and a coarse topographic order exists in the noradrenergic innervation of cortex. Since noradrenergic fibers travel long distances within the cortical grey matter, a small lesion of frontal cortex can have far-reaching effects on the innervation of distant, more caudal regions of cortex. The coeruleocortical projection has properties that differ from those of the best characterized cortical afferents and may be a useful model for the study of other ascending monoamine systems. The tangential, intracortical trajectory of the noradrenergic fibers would confer upon the coeruleo-cortical system the capacity to modulate neuronal activity simultaneously through a vast expanse of neocortex. A formulation of cortical organization is presented which integrates the tangential organization of the coeruleo-cortical projection with the concept of columnar organization of cortex.     

Effects of manipulating catecholamines on the incidence of the preovulatory surge of of luteinizing hormone and ovulation in the rat: evidence for a necessary involvement of hypothalamic adrenaline in the normal or 'midnight' surge

The preovulatory surge of luteinizing hormone reaches a maximum at 18.00 h on the day of pro-oestrus in female rats maintained with regular lighting from 06.00 to 20.00 h. This surge is initiated by a discharge of luteinizing hormone-releasing hormone into hypophysial portal blood. In this study, drugs which affect catecholamine-mediated neurotransmission were administered on the day of pro-oestrus and the effects on serum concentrations of luteinizing hormone and on subsequent ovulation were observed. alpha-Methyl-p-tyrosine, diethyldithiocarbamate and SKF 64139 inhibit catecholamine synthesis at the level of tyrosine hydroxylase, dopamine beta-hydroxylase and phenylethanolamine N-methyltransferase, respectively. Although alpha-methyl-p-tyrosine suppressed ovulation, it had a negligible effect on the incidence of the preovulatory surge. In contrast, the various treatments with diethyldithiocarbamate and SKF 64139 resulted in a minimal occurrence of the 18.00 h surge; at relatively low doses, however, these drugs frequently elicited a surge at 22.00 or 24.00 h which invariably resulted in ovulation. The failure of the surge after diethyldithiocarbamate or SKF 64139 was not associated with a loss of pituitary sensitivity to luteinizing hormone-releasing hormone. In terms of the hypothalamic concentration of dopamine, noradrenaline, adrenaline and 5-hydroxytryptamine at 18.00 h on pro-oestrus, the only common effect of diethyldithiocarbamate and SKF 64139, given in a dose which blocks the surge, was a severe depletion of adrenaline; alpha-methyl-p-tyrosine failed to produce this effect despite inducing a marked depression of dopamine and a moderate loss of noradrenaline. Neither the increase in hypothalamic dopamine after diethyldithiocarbamate, nor the alpha 2 receptor blocking properties of SKF 64139 appear to be relevant in this context since injections of L-dopa or piperoxane, an alpha 2 receptor antagonist, were without effect on the surge or ovulation. The failure of the surge after prazosin, an alpha 1 receptor antagonist, indicates that the function of adrenaline may be mediated postsynaptically by alpha 1 receptors. Clonidine, an alpha 2 receptor agonist which reduces the turnover rate of hypothalamic adrenaline, had effects of the surge and ovulation which were comparable to those of diethyldithiocarbamate and SKF 64139, the relatively low doses causing some of the surges to occur at 24.00 instead of 18.00 h and higher doses suppressing the surge at both times and thus preventing ovulation.(ABSTRACT TRUNCATED AT 400 WORDS)     

Infantile hemangioma is a proliferation of beta 4-negative endothelial cells adjacent to HLA-DR-positive cells with dendritic cell morphology

Although hemangioma is referred as to the most common tumor in infancy, the underlying pathogenetic events and the biologic origin of this benign vascular neoplasm have remained obscure. By using immunohistochemistry on frozen sections of infantile hemangiomas, we show here that proliferating endothelial cells abundantly expressed alpha(v)beta(3) but lacked beta(4) integrins. Instead, regressing and involuting infantile hemangiomas due to treatment with IFN-alpha showed positive staining of beta(4) integrin, which might point to the angiogenic significance of beta(4) integrin in infantile hemangiomas. Moreover, immunofluorescence analysis revealed the existence of HLA-DR(+), mostly CD68(+) and partly DC-SIGN/CD209(+) cells with dendritic cell morphology in the intimate vicinity of hemangiomatous vessels. Such cells were also detected in the dermal microvascular unit in normal skin. The coupled occurrence of vascular structures and perivascular cells that were stained positive with markers of monocyte or macrophage or dendritic cells might suggest that the development of infantile hemangioma is a result of vasculogenesis, that is, the formation of primitive blood vessels from angioblasts, rather than of angiogenesis, that is, the sprouting of capillaries from preexisting vessels.     

A rapid method for the inactivation of virus infectivity prior to assay for interferons

Virus infectivity in samples of culture medium or suspensions of animal tissue which are required for interferon assay can be rapidly and conveniently inactivated by overnight incubation with beta-propiolactone (BPL). As BPL hydrolyses spontaneously samples can be assayed with no further treatment. BPL does not affect the interfering activity of alpha, beta or gamma mouse interferons.     

IMPs, VIMs and SPMs: the diversity of metallo-β-lactamases produced by carbapenem-resistant Pseudomonas aeruginosa in a Brazilian hospital

Pseudomonas aeruginosa isolates (n=183), collected from bacteraemic patients hospitalised in Sao Paulo Hospital (Brazil) during 2000-2001, were screened for susceptibility to antimicrobial agents. The polymyxins were the most active compounds (100% susceptibility), followed by amikacin and cefepime (59.0%), meropenem (57.4%), and imipenem and gentamicin (55.2%). Imipenem-resistant isolates were ribotyped and screened for production of metallo-beta-lactamases (MBLs) by PCR with primers for bla(IMP), bla(VIM) and bla(SPM). MBL production was detected in 36 isolates (19.7% of the entire collection; 43.9% of the imipenem-resistant isolates) and the MBLs included SPM-1-like (55.6%), VIM-2-like (30.6%) and IMP-1-like (8.3%) enzymes.