二酯酰甘油-蛋白激酶C信号传导系统和细胞因子与糖尿病肾病的关系

目的研究糖尿病大鼠肾小球中蛋白激酶C(PKC)的活性变化及转化生长因子-β1(TGF-β1)和血管内皮细胞生长因子(VEGF)的表达情况,探讨3者之间的相互关系及其与糖尿病肾病(DN)发生、发展的相关性。方法选用雄性SD大鼠,用链脲佐菌素制备大鼠糖尿病实验模型,随机分为正常对照组、糖尿病2周(DM2)组和糖尿病4周(DM4)组。大鼠断头处死,分离肾小球,提取纯化胞浆及胞膜蛋白。利用[r-32P]-ATP底物磷酸化的方法检测胞浆及胞膜PKC活性;用免疫组织化学法检测VEGF和TGF-β1在各组大鼠肾小球及肾小管中的表达。结果①DM2、DM4组肾小球细胞内总的PKC活性与对照组无显著性差异,胞浆PKC活性略有下降,但相差不显著(P>0.05);DM2、DM4组肾小球细胞膜PKC活性均明显高于正常对照组(P<0.05),且细胞膜PKC活性与肾脏肥大指数(肾重/体质量)和内生肌酐清除率(Ccr)呈正相关。②DM2、DM4组VEGF和TGF-β1的表达均高于正常对照组(P<0.01)。③肾小球细胞膜PKC活性与VEGF和TGF-β1的表达呈正相关。结论高血糖慢性刺激可引起肾小球PKC活性增高,并上调TGF-β1和VEGF的表达,进一步导致肾小球滤过膜通透性和滤过率增加,这在糖尿病早期肾内血流动力学改变中发挥着重要的调控作用。     

叶酸对冠心病大鼠血清同型半胱氨酸和血管内皮生长因子的影响

目的观察叶酸、维生素B12对冠心病大鼠模型血清同型半胱氨酸(HCY)、血管内皮生长因子(VEGF)的影响。方法将健康4周龄雄性SD大鼠60只(体重110±10g)随机分为正常对照组、高脂饮食组、叶酸组、维生素B12组、叶酸及维生素B12组。正常对照组给予普通饲料喂养;余各组给予高脂饲料喂养,第12周末测定各组大鼠血清血脂、HCY、VEGF含量;光镜、电镜查看腹主动脉组织学改变;利用Western blot检测各组大鼠腹主动脉中VEGF的表达。结果用药12周后,单独应用叶酸或联合维生素B12都能有效地降低冠心病模型大鼠血清HCY水平(P<0.01),升高血清和血管中VEGF水平(P<0.05),同时能改变VEGF的蛋白表达(P<0.05)。结论高脂饮食可以影响血清和血管中HCY、VEGF的水平,而应用叶酸或联合维生素B12可以改善或减轻高脂状态所造成的血管内皮损伤。     

2型糖尿病患者血清Lp(a)水平及其与血管并发症的关系

目的 观察2型糖尿病患者血清Lp(a)水平的变化及其与血管并发症的关系。方法 选择90例糖尿病患者和35例健康对照者,根据血管并发症的不同分为单纯糖尿病组、糖尿病合并高血压、冠心病、视网膜病变及糖尿病肾病组。采用免疫透射比浊法测定其血清中Lp(a)水平,采用酶法测定其血清中TC、TG、HDL、VLDL的水平。结果 单纯糖尿病组及糖尿病合并各种血管并发症组的血清Lp(a)水平明显高于正常对照组,同时,还发现有血管并发症组的血清Lp(a)水平明显高于单纯糖尿病组,血清Lp(a)水平与常见的血脂指标无明显相关关系。结论 Lp(a)是2型糖尿病血管并发症发生发展的一个独立危险因素。     

经鼻腔、蝶窦至海绵窦手术入路的解剖学基础

1987年,M.Loyo 首次报道经鼻腔、蝶窦而入海绵窦,处理海绵窦内血管疾患的新手术入路.本文作者用30个(60侧)尸头及51个干颅骨(102侧)做了蝶窦的外科解剖观察,除为经蝶窦而达垂体的手术入路提供了数据外,本文侧重论证经蝶窦而达海绵窦手术入路的解剖基础及优点。     

PPAR-γ激活对血管平滑肌细胞外基质释放及结缔组织生长因子表达的影响

目的观察PPAR-γ激活对血管紧张素Ⅱ诱导的体外培养条件下大鼠血管平滑肌(VSMCs)的细胞外基质(ECM)释放及结缔组织生长因子(CTGF)表达的影响。方法原代培养大鼠VSMCs,用不同浓度PPAR-γ激动剂rosiglitzone和/或抑制剂GW9662、BADGE预处理后,加入0.1μmol/L血管紧张素Ⅱ(AngⅡ)刺激24h。比色法检测各组细胞培养液中羟脯氨酸含量,实时荧光定量RT-PCR方法检测各组三型胶原(ColⅢ)、层粘连蛋白(FN)及CTGFmRNA表达,Western blotting检测各组CTGF、PPAR-γ蛋白表达情况,基于ELISA的DNA-binding检测各组PPAR-γ活性。结果 AngⅡ可增加VSMCs PPAR-γ表达,但明显抑制其活性(P<0.05,vs.Control),PPAR-γ激动剂rosiglitazone可显著增加PPAR-γ蛋白表达及活化(P<0.05,vs.AngⅡ)。rosiglitazone可降低细胞培养液中羟脯氨酸含量,下调VSMCs中ColⅢ、FN、CTGF mRNA表达,抑制CTGF蛋白表达,而其他PPAR-γ激动剂(pioglitazone、15-d-PGJ2)均有相似作用,PPAR-γ拮抗剂GW9662及BADGE可拮抗这一作用。结论在VSMCs中,PPAR-γ激活可抑制AngⅡ诱导的CTGF表达,同时抑制ECM沉积。提示PPAR-γ可能在血管纤维化中起重要作用。     

超声观测高同型半胱氨酸血症兔内皮功能损伤与血管细胞粘附分子的关系

目的研究高同型半胱氨酸血症(HHcy)兔血浆细胞粘附分子-1(VCAM-1)及一氧化氮(NO)的变化与内皮依赖性舒张功能(EDD)的关系,探讨内皮功能损伤的机理。方法将22只新西兰兔随机分为两组,每组11只,分别喂食正常饲料(正常对照组)、L-蛋氨酸[0.8g/(kg.d)]饲料(蛋氨酸组),分别于0、20、40、60、80d取血检测NO和VCAM-1的浓度,同时应用高分辨力超声检测其髂外动脉EDD的改变。结果①与正常对照组相比,蛋氨酸组兔髂外动脉的EDD显著降低,且呈明显的时间依赖性[80d,(-1.74±3.58)%vs.0d,(13.43±4.13)%,P<0.01];②与正常对照组相比,蛋氨酸组兔血浆中NO明显降低[80d,(217.43±27.38)μmol/L vs.0d,(379.75±56.83)μmol/L,P<0.05],血浆VCAM-1却明显升高[80d,(0.091 2±0.009 7)ng/mLvs.0d,(0.047 2±0.004 7)ng/mL,P<0.01],亦呈现明显的时间依赖性。结论高分辨力超声检测到的内皮依赖性舒张功能降低与血浆粘附分子明显相关,同型半胱氨酸(Hcy)导致内皮功能损伤是一个多途径的综合损伤。     

An experimental study of pioglitazone in treating vascular dementia

Objective To compare the therapeutic effects of different doses of pioglitazone, a kind of peroxisome proliferator-activated receptor γ (PPARγ) agonist, on vascular dementia and explore how pioglitazone affects cerebral ischemia. Methods Modified Pulsinelli's vessel ligation was used to establish a vascular dementia model in rats. Recognition, learning and memory were evaluated by Morris's water maze test. Immunoenzyme staining was used to determine the number of nerve cells. Immunofluorescence double-staining was used to examine the expression of PPARγ/nerve cells and PPARγ/astrocytes in different groups. Results Both in pioglitazone groups and sham-operation group, the latency was reduced significantly compared to that in control group (P<0.01). Sham-operation group had the largest number of neurons in the cortex, followed by low-dose pioglitazone group and high-dose pioglitazone group, and control group came last. Compared with control group, pioglitazone groups had more PPARγ expression in nerve cells, and the fluorescence intensity of PPARγ was stronger. Conclusion Pioglitazone can induce the expression of PPARγ in neuron endochylema and astrocyte endochylema to protect nerve cells, and then to improve spatial learning and memory function in VD rats.     

Glutamate enhances the expression of vascular endothelial growth factor in cultured SD rat astrocytes

Objective To study the effect of glutamate on the expression of vascular endothelial growth factor (VEGF) mRNA and protein in cultured rat astrocytes. Methods Cultured rat astrocytes were randomly divided into 6 groups: control group (C), glutamate group (G), QA group (Q), DCG-IV group (D), L-AP4 group (L) and glutanmte-FMCPG gronp (G+M). Cells were cultured under nomoxic condition (95% air, 5% CO2). RT-PCR and ELISA methods were used to detect the expression of VEGF mRNA and protein in cultured astrocytes, respectively. G+ M group was preincubated with lmM MCPG for 30 min prior to the stimulation with glutamate. There were 7 time points at 0,4,8,12,16,24 and 48 h in each group except G+M group. Results The expression of VEGF mRNA and protein did not differ significantly among D group, L group and C group. Different from that in C group, the expression of VEGF mRNA and protein could be enhanced both in a dose-dependent and time-dependent manner in G group and Q group. Meanwhile, the enhanced expression of VEGF mRNA and protein in G group was completely suppressed by MCPG after 24 h. Conclusion Glutamate can increase the expression of VEGF mRNA and protein in cultured astrocytes, which may be due to the activation of group I metabotropic glutamate receptors in astrocytes.     

雷帕霉素对小鼠H_(22)肝癌细胞生长增殖的影响

目的 研究雷帕霉素(rapamycin, RPM)对H_(22)肝癌细胞生长增殖的影响.方法 体外培养小鼠H_(22)肝细胞癌株,分别与RPM、CsA、FK506和5-Fu共同孵育48 h,进行MTT实验.流式细胞仪测定各组H_(22)细胞的细胞周期变化,ELISA法测定各组上清液中VEGF含量.体内实验建立H_(22)肝细胞癌皮下移植瘤模型,同时完成C57BL/6→BALB/c小鼠异体皮肤移植模型.给予RPM、CsA、FK506和5-Fu灌胃,观察皮片存活情况.获取实验小鼠血清及肿瘤组织.计算各组肿瘤体积,通过CD34免疫组化染色测定各组肿瘤组织的微血管密度(MVD).结果 剂量为0.01、0.1、1 mg/L的RPM对对数生长的H_(22)肝细胞具有细胞毒性,抑制H_(22)小鼠肝癌细胞增殖,培养上清液中的VEGF浓度较对照组显著降低(P<0.05),细胞周期分析显示S期细胞数较其他免疫抑制剂组显著减少(P<0.05).体内实验显示给予1.5 mg/(kg·d)和4.5 mg/(kg·d)的RPM与5 mg/(kg·d) FK506、20 mg/(kg·d) CsA的皮片存活时间相等,而肿瘤体积显著减小(P<0.05).与对照组相比,实验剂量RPM显著降低了荷瘤小鼠血清中的VEGF含量(P<0.05),同时瘤组织内的MVD显著减少(P<0.05).结论 体外实验研究和动物实验证实,RPM具有抗免疫排斥和抗肿瘤增殖的特点,可能在肝移植治疗肝脏恶性肿瘤方面发挥优势.