Clinical features and hematological findings of COVID-19 patients with blood transfusion

This paper aims to illustrate the clinical characteristics, hematological findings, and blood transfusion information of Coronavirus disease 2019 (COVID-19) patients. Twenty-three COVID-19 patients were treated and transfused with blood products in Wuhan First Hospital from February 12 to March 20, 2020. The patients were divided into a survivor group and a non-survivor group, respectively, according to whether the patient had been discharged or died. The results demonstrated at the time of initial blood transfusion, that the non-survivor group possessed a lower platelet (PLT) than that of the survivor group (P<0.001), and PLT were below the normal range in 6 (85.7%) non-survivor group and in 2 (12.5%) survivor group (P<0.01). Over half of these patients had abnormalities in fibrinogen (FIB), activated partial thromboplastin time (APTT), prothrombin time (PT), and international normalized ratio (INR), but no significant difference was found between the non-survivor group and survivor group. The non-survivor group had a dramatically higher D-Dimers and disseminated intravascular coagulation (DIC) scores than those of the survivor group (P<0.01). Six (85.7%) non-survivors but none of the survivors had a DIC score greater than 6 (P<0.001). Fifteen (93.8%) survivors and 2 (28.6%) non-survivors were transfused with RBC (P<0.01). The non-survivors (5/7) possessed a higher proportion for using AP than the survivors (2/16). The study suggests that COVID-19 patients who undergo blood transfusion usually possess coagulation dysfunction, and DIC may be closely related to deteriorating clinical outcomes.     

The Impact of Various Platelet Indices as Prognostic Markers of Septic Shock

IntroductionPlatelet indices, including mean platelet volume (MPV), are readily available blood tests, although their prognostic value in patients with septic shock has not been fully explored. Current evidence has found contradictory results. This study aims to explore the behavior of platelet indices in septic shock and their clinical prognostic value.MethodsCharts of septic shock patients from January to December 2012 in a tertiary medical center in Northern China were reviewed retrospectively. Platelet indices were recorded during the first five consecutive days after admission, as well as the penultimate and the last day of hospital stay. The data were compared between surviving and non-surviving patients.ResultsA total of 124 septic shock patients were enrolled. Thirty-six of the patients survived and 88 of them expired. MPV in the non-survivor group was higher than that of the survivor group, especially on the last day. PDW and PLCR showed increased trends, while PCT and PLT decreased in the non-survivor group. Among the PLT indices, MPV had the highest area under the receiver operating characteristic curve (0.81) with a precision rate of 75.6% at a cut-off of 10.5.Compared with other more usual septic shock prognostic markers, MPV is second only to lactate for the highest area under the curve.ConclusionA statistically significant difference was seen between survivors and non-survivors for platelet indices which make them easily available and useful prognostic markers for patients in septic shock.     

Dynamic changes of platelet-related parameters and their associations with clinical outcomes in COVID-19 patients during hospitalization

This paper aims to analyze dynamic changes in platelet-related indicators and their associations with clinical outcomes in COVID-19 patients. 220 COVID-19 patients hospitalized in the General Hospital of Central Theater Command the PLA from January 21, 2020 to March 25, 2020, were enrolled. These patients were firstly divided into non-severe and severe groups in accordance with disease severity on admission. The patients of the severe group were further divided into survivors and non-survivors according to whether the patient was discharged or deceased. The results demonstrated that IL-6 had negative correlations with PLT (R=?0.318, P<0.001) and PCT (R=?0.323, P<0.001). However, no significant correlations or only weak correlations were found between the platelet-related parameters (PLT, MPV, PDW, PCT, and P-LCR) and other indexes of coagulation and inflammation (PT, APTT, FIB, D-D, and CRP). The dynamic changes of platelet-related parameters in non-severe patients and survivors during hospitalization showed very similar trends and changing rules, while those in the non-survivor group were considerably different. After adjusting for demographic variables and coexisting disorders, the patients with nadir platelet counts of (100–150), (50–100), and (0–50), respectively, possessed a significantly increased risk of mortality [(OR=1.81, 95% CI, 0.2–16.44, P>0.05), (OR=9.91, 95% CI, 1.36–72.2, P<0.05), and (OR=53.81, 95% CI, 5.85–495.22, P<0.001)] with (150–) as the reference. This study suggests that changing trends of the platelet-related parameterrs during hospitalization especially in the first week after admission, are of great significance for predicting clinical outcomes.     

Is COPD a Progressive Disease? A Long Term Bode Cohort Observation

BackgroundThe Global Initiative for Obstructive Lung Diseases (GOLD) defines COPD as a disease that is usually progressive. GOLD also provides a spirometric classification of airflow limitation. However, little is known about the long-term changes of patients in different GOLD grades.ObjectiveExplore the proportion and characteristics of COPD patients that change their spirometric GOLD grade over long-term follow-up.MethodsPatients alive for at least 8 years since recruitment and those who died with at least 4 years of repeated spirometric measurements were selected from the BODE cohort database. We purposely included the group of non survivors to avoid a “survival selection” bias. The proportion of patients that had a change (improvement or worsening) in their spirometric GOLD grading was calculated and their characteristics compared with those that remained in the same grade.ResultsA total of 318 patients were included in the survivor and 217 in the non-survivor groups. Nine percent of survivors and 11% of non survivors had an improvement of at least one GOLD grade. Seventy one percent of survivors and non-survivors remained in the same GOLD grade. Those that improved had a greater degree of airway obstruction at baseline.ConclusionsIn this selected population of COPD patients, a high proportion of patients remained in the same spirometric GOLD grade or improved in a long-term follow-up. These findings suggest that once diagnosed, COPD is usually a non-progressive disease.     

Assessment of Haemostasis in Disseminated Intravascular Coagulation by Use of Point-of-Care Assays and Routine Coagulation Tests,in Critically Ill Patients; A Prospective Observational Study

Background

Disseminated intravascular coagulopathy (DIC) relates to the consumption of coagulation factors and platelets with bleeding and micro thrombosis events.

Aim

The aim of this study was to compare haemostasis parameters in critically ill patients with DIC versus patients without DIC, and in survivors versus non-survivors over time. Correlations between the DIC-score, the degree of organ failure and the haemostasis were assessed.

Method

Patients admitted to the intensive care unit with a condition known to be associated with DIC and with an expected length of stay of >3 days were included. Routine laboratory tests, prothrombin time, activated partial thromboplastin time, platelet count, fibrinogen concentration and D-dimer were measured. Coagulation and platelet function were assessed with two point-of-care devices; Multiplate and ROTEM. DIC scores were calculated according to the International Society on Thrombosis and Haemostasis and Japanese Association for Acute Medicine.

Results

Blood was sampled on days 0–1, 2–3 and 4–10 from 136 patients with mixed diagnoses during 290 sampling events. The point-of-care assays indicated a hypocoagulative response (decreased platelet aggregation and reduced clot strength) in patients with DIC and, over time, in non-survivors compared to survivors. Patients with DIC as well as non-survivors had decreased fibrinolysis as shown by ROTEM. DIC scores were higher in non-survivors than in survivors.

Conclusions

Patients with DIC displayed signs of a hypocoagulative response and impaired fibrinolysis, which was also evident over time in non-survivors. Patients with DIC had a higher mortality rate than non-DIC patients, and DIC scores were higher in non-survivors than in survivors.     

COVID-19 Survivor Patients Carrying the Rs35705950 Risk Allele in MUC5B Have Higher Plasma Levels of Mucin 5B

Background: Genetic susceptibility to infectious diseases is partly due to the variation in the human genome, and COVID-19 is not the exception. This study aimed to identify whether risk alleles of known genes linked with emphysema (SERPINA1) and pulmonary fibrosis (MUC5B) are associated with severe COVID-19, and whether plasma mucin 5B differs according to patients’ outcomes. Materials and methods: We included 1258 Mexican subjects diagnosed with COVID-19. We genotyped rs2892474 and rs17580 of the SERPINA1 gene and rs35705950 of MUC5B. Based on the rs35705950 genotypes, mucin 5B plasma protein levels were quantified. Results: Homozygous for the risk alleles of the three polymorphisms were found in less than 5% of the study population, but no statistically significant difference in the genotype or allele association analysis. At the protein level, non-survivors carrying one or two copies of the risk allele rs35705950 in MUC5B (GT + TT) had lower levels of mucin 5B compared to the survivors (0.0 vs. 0.17 ng/mL, p = 0.0013). Conclusion: The polymorphisms rs28929474 and rs17580 of SERPINA1 and rs35705950 of MUC5B are not associated with the risk of severe COVID-19 in the Mexican population. COVID-19 survivor patients bearing one or two copies of the rs35705950 risk allele have higher plasma levels of mucin 5B.     

Mortality and pre-hospitalization use of low-dose aspirin in COVID-19 patients with coronary artery disease

To determine whether pre-hospitalization use of aspirin is associated with all-cause mortality in coronavirus disease 2019 (COVID-19) patients with coronary artery disease (CAD). We recruited 183 adult patients with CAD diagnosed with COVID-19, including 52 taking low-dose aspirin (mean [SD] age, 69.7 [1.1] years; 59.6% men) and 131 without using aspirin (mean [SD] age, 71.8 [0.9] years; 51.9% men), who were admitted in the Tongji hospital in Wuhan, China from January 10, 2020 to March 30, 2020. There was no difference on in-hospital mortality between aspirin group and non-aspirin group (21.2% vs. 22.1%, P = .885). Similarly, for critically severe COVID-19 patients, the mortality in aspirin group was close to that in non-aspirin group (44% vs. 45.9%, P = .872). Moreover, the percentage of patients with CAD taking low-dose aspirin did not differ between those survivors and non-survivors (28.7% vs. 27.5%, P = .885). Meanwhile, the usage of aspirin was not correlated with all-cause mortality in multivariate analysis (OR = 0.944, 95% CI: 0.411-2.172, P = .893). Collectively, our study suggested that the pre-hospitalization use of low-dose aspirin was not associated with the clinical outcome of patients with CAD hospitalized with COVID-19 infections.     

低氧联合LPS刺激对星形胶质细胞中炎性因子和BNIP3表达的影响*

目的:探讨在低氧联合脂多糖(LPS)作用下,星形胶质细胞中B淋巴细胞瘤-2/腺病毒E1B 19-kD相互作用蛋白3(BNIP3)的表达和炎症反应变化。方法:将体外培养的原代星形胶质细胞和神经元进行下列分组:常氧组、LPS组、低氧组和LPS+低氧组(每组设置3个复孔)。LPS处理后,低氧组和LPS+低氧组放入低氧细胞孵箱,LPS组和常氧组放入正常的细胞孵箱。LPS浓度:100 ng/ml,氧气浓度为0.3%。处理时间为24 h。原代的星形胶质细胞进行上述的分组,时间点设为6 h、12 h和24 h。Western blot检测BNIP3的表达变化,RT-PCR和ELISA分别检测星形胶质细胞的肿瘤坏死因子-ɑ(TNF-ɑ)、白细胞介素-1β(IL-1β)和白细胞介素6(IL-6)mRNA水平变化和分泌情况。结果:与常氧组比较,低氧组炎症因子的表达没有变化,LPS组和LPS＋低氧组的炎症因子TNF-ɑ、IL-1β和IL-6 mRNA水平升高(P＜0.01);与LPS组比较,LPS＋低氧组炎症因子IL-1β和IL-6 mRNA水平进一步升高(P＜0.05,P＜0.01)。与常氧组比较,低氧组炎症因子的分泌水平没有变化,LPS组和LPS＋低氧组的炎症因子TNF-ɑ和IL-6 分泌水平升高(P＜0.01),IL-1β的水平没有变化;与LPS组比较,LPS＋低氧组炎症因子TNF-ɑ和IL-6分泌水平没有进一步升高。BNIP3在体外培养的神经元和星型胶质细胞中都有表达;在星形胶质细胞中,与常氧组比较,LPS组BNIP3的表达没有变化,低氧组和LPS+低氧组BNIP3的表达明显增加(P＜0.01);在神经元中,与常氧组比较,LPS组BNIP3的表达没有变化,低氧组和LPS+低氧组BNIP3的表达增加(P＜0.05,P＜0.01);与神经元的低氧组比较,星形胶质细胞的低氧组BNIP3的表达增加更明显(P＜0.01)。在星形胶质细胞中LPS联合低氧刺激6、12、24 h后BNIP3蛋白的表达,与常氧组相同时间点比较,LPS组BNIP3的表达没有变化,低氧组和LPS+低氧组BNIP3的表达增加(P＜0.05,P＜0.01);与低氧组相同时间点比较,6 h和12 h的LPS＋低氧组BNIP3的表达增加的更高(P＜0.01)。结论:低氧联合LPS刺激可以增强星形胶质细胞的炎症反应,LPS能增加低氧下星形胶质细胞中BNIP3的表达,提示BNIP3在星形胶质细胞的炎性反应中可能具有一定的调节作用。     

PKC抑制剂对力竭运动大鼠肾脏裂孔膜蛋白表达的影响*

目的: 观察大鼠在一次性力竭运动后肾脏裂孔膜蛋白的表达水平,探究PKC抑制剂对其蛋白表达水平的影响,揭示PKC在运动性蛋白尿形成中的作用机制。方法: SD雄性大鼠30只随机分为对照组(C)、运动组(E)、运动联合PKC抑制剂组(EPI),每组10只。E组和EPI组大鼠分别进行一次性跑台力竭运动(25 m/min),EPI组大鼠运动前1 d及1 h腹腔注射PKC抑制剂白屈菜红碱(chelerythrine,5 mg/kg),C组和E组注射相应体积的生理盐水。运动后即刻麻醉后,取血液、尿液及肾脏组织,使用化学比色法检测尿蛋白、尿酸、尿糖、血尿素、血尿酸、血糖水平,使用荧光探针法检测肾脏ROS水平,使用Western blot法检测肾脏PKC、Nox2、Nox4、nephrin、podocin蛋白表达。结果: ①与C组相比,E组尿蛋白、尿酸、尿糖、血尿素、血尿酸显著增多(P＜0.05),血糖显著减少(P＜0.01),肾脏ROS生成显著增多(P＜0.01),肾脏nephrin、podocin蛋白表达明显降低(P＜0.05),PKC、Nox2、Nox4蛋白表达明显增多(P＜0.05);②与E组比,EPI组尿蛋白、尿糖、血尿素显著减少(P＜0.05),血糖显著增加(P＜ 0.01),肾脏ROS生成显著降低(P＜0.01),EPI组肾组织中nephrin、podocin蛋白表达明显增加(P＜0.05),PKC、Nox2蛋白表达明显降低(P＜0.05)。结论: 一次性力竭运动通过PKC/NOX/ROS途径使大鼠肾脏裂孔膜蛋白nephrin、podocin表达下调;PKC抑制剂缓解力竭运动导致的肾脏裂孔膜蛋白表达下降,预防运动性蛋白尿的发生。     

有氧运动联合螺旋藻多糖对糖尿病大鼠学习记忆能力的影响及其机制*

目的:研究有氧运动联合螺旋藻多糖对糖尿病大鼠学习记忆能力及对海马脑组织p75^NTR信号相关蛋白的影响。方法:采用高糖高脂饮食喂养4周配合低剂量腹腔注射的方法复制Ⅱ型糖尿病大鼠实验模型。成模后随机分为:模型组(B组)、运动+糖尿病组(C组)、螺旋藻多糖+糖尿病组(D组)、运动+螺旋藻多糖+糖尿病组(E组),另设正常对照组(A组)。共5组,每组12只。C组和E组施加6周的有氧游泳训练,D组和E组给予螺旋藻多糖灌胃6周,A组不施加任何干预。用Morris水迷宫检测大鼠学习记忆能力;Tunel染色法检测神经元细胞凋亡情况;ELISA法检测BDNF含量,Western blot法检测p75^NTR和cleaved caspase-3蛋白表达,免疫组化法检测cleaved caspase-3表达变化。同时观察大鼠随机血糖、血胰岛素等指标的变化。结果:①与A组比较,B组不同时间点上的体重均显著降低(P＜0.01);与B组比较,C、D、E组在不同时间点上的体重差异均无统计学意义(P均＞0.05)。与A组比较,B组的血糖和胰岛素水平显著升高(P＜0.01);与B组比较,干预各组的血糖和胰岛素水平显著降低(P＜0.05或P＜0.01)。②与A组比较,B组寻找平台的逃避潜伏期明显延长(P＜0.01),目标象限时间和穿越平台次数显著减少(P＜0.01);与B组比较,各干预组逃避潜伏期均显著缩短(P＜0.05或P＜0.01),穿越平台次数均显著增加(P＜0.05或P＜0.01),其中以E组效果最好。③与B组比较,干预各组海马神经细胞凋亡减少,p75^NTR、cleaved caspase-3蛋白表达显著降低(P＜0.05或P＜0.01),BDNF含量明显增加(P＜0.05或P＜0.01)。其中以E组效果更为明显。结论:有氧运动与螺旋藻多糖能有效改善糖尿病大鼠学习记忆,其中以两者联合组的效果更为显著,其机制可能与其更好的调节p75^NTR信号相关蛋白的表达,一定程度抑制细胞凋亡,从而有效改善Ⅱ型糖尿病学习记忆,发挥神经保护作用有关。     

儿茶酚抑素在大鼠肾性高血压中的作用及可能机制

目的：观察儿茶酚抑素（CST）在两肾一夹（2K1C）肾性高血压大鼠中的表达改变,并初步探讨其对肾性高血压的影响及作用机制。方法：36只SD大鼠随机分为假手术组（Sham）（n=15）和肾性高血压模型组（Model组）（n=21）。Model组采用两肾一夹（2K1C）手术法建立肾性高血压模型,Sham组手术操作同Model组,但不结扎左肾动脉,每周动态监测大鼠尾动脉血压。6周后各组大鼠行颈总动脉插管测定动脉压,Model组再随机分为2K1C组（n=15）与2K1C+CST组（n=6）。2K1C+CST组经颈外静脉一次性给予CST （80 μg/100 g·BW）,Sham组与2K1C组给予等容积的生理盐水。各组动物经测血压、采集血标本后被处死,称取左心室加室间隔（LV+S）重量,计算（左心室+室间隔）/体重;高效液相色谱-电化学方法测定血浆中去甲肾上腺素（NE）含量,ELISA法测定血浆CST含量,硝酸还原酶法测定血浆及心室肌一氧化氮（NO）浓度;Western blot法检测延髓、肾上腺髓质、左心室和肾脏的嗜铬蛋白A （Chga）及左心室内皮型一氧化氮合酶（eNOS）、诱导型一氧化氮合酶（iNOS）蛋白表达量。结果：①与Sham组相比,2K1C组大鼠尾动脉压显著升高,左心室明显肥厚（P<0.01）;血浆NE含量增高246%（P<0.01）,CST水平降低56%（P<0.05）;延髓Chga含量增高108%,左心室和肾脏分别降低60%和30%（P<0.05）;左心室NO含量增高46%,血浆NO含量增高24%（P<0.05）;左心室eNOS、iNOS蛋白表达分别增高66%和40%（P<0.05）;②外源性CST显著降低2K1C大鼠颈总动脉压（P<0.05）;③与2K1C组相比,2K1C+CST组左心室和血浆NO含量分别增高35%和19%（P<0.05）;左心室eNOS蛋白表达高50%（P<0.05）,而iNOS表达无显著统计学差异。结论：两肾肾性高血压时大鼠CST表达下调,外源性CST可能通过NO/NOS系统降低肾性高血压的作用,推测CST可能与肾性高血压的发生发展有关。     

京尼平保护高糖诱导损伤小鼠胰岛MIN6细胞的机制

京尼平(genipin,Gen)是一种重要的抗氧化物,在细胞内抵抗氧化应激损伤过程中发挥重要的作用.为了探讨京尼平对高糖诱导损伤的小鼠胰岛MIN6细胞的影响,采用CCK-8法检测细胞存活率.高糖损伤组细胞活力下降(P＜0.05),京尼平作用高糖损伤的细胞后,细胞活力增加(P＜0.05);小鼠胰岛素(insulin)检测...     

Increased sTREM-1 plasma concentrations are associated with poor clinical outcomes in patients with COVID-19

Patients with sepsis display increased concentrations of sTREM-1 (soluble Triggering Receptor Expressed on Myeloid cells 1), and a phase II clinical trial focusing on TREM-1 modulation is ongoing. We investigated whether sTREM-1 circulating concentrations are associated with the outcome of patients with coronavirus disease 2019 (COVID-19) to assess the role of this pathway in COVID-19. This observational study was performed in two independent cohorts of patients with COVID-19. Plasma concentrations of sTREM-1 were assessed after ICU admission (pilot cohort) or after COVID-19 diagnosis (validation cohort). Routine laboratory and clinical parameters were collected from electronic patient files. Results showed sTREM-1 plasma concentrations were significantly elevated in patients with COVID-19 (161 [129–196] pg/ml) compared to healthy controls (104 [75–124] pg/ml; P<0.001). Patients with severe COVID-19 needing ICU admission displayed even higher sTREM-1 concentrations compared to less severely ill COVID-19 patients receiving clinical ward-based care (235 [176–319] pg/ml and 195 [139–283] pg/ml, respectively, P = 0.017). In addition, higher sTREM-1 plasma concentrations were observed in patients who did not survive the infection (326 [207–445] pg/ml) compared to survivors (199 [142–278] pg/ml, P<0.001). Survival analyses indicated that patients with higher sTREM-1 concentrations are at higher risk for death (hazard ratio = 3.3, 95%CI: 1.4–7.8). In conclusion, plasma sTREM-1 concentrations are elevated in patients with COVID-19, relate to disease severity, and discriminate between survivors and non-survivors. This suggests that the TREM-1 pathway is involved in the inflammatory reaction and the disease course of COVID-19, and therefore may be considered as a therapeutic target in severely ill patients with COVID-19.     

不同海拔汉族健康人大循环及微循环特征的对比

目的: 观察青海不同海拔高度的果洛(4 100 m)和互助(2 600 m)与平原地区上海(4 m)汉族健康人大循环及微循环特征。方法: 将青海果洛28名年龄(45.62±10.15)岁、青海互助27名年龄(47.25±8.43)岁、上海20名年龄(43.12±8.28)岁的三地区汉族健康人分为:果洛组(GL)、互助组(HZ)和上海组(SH);抽取静脉血分别行血常规:红细胞(RBC)、血红蛋白(HGB)、红细胞压积(HCT)、血小板(PLT)的检测;凝血功能:凝血酶原时间(PT)、国际标准化比值(INR)、纤维蛋白原(Fib)、部分凝血活酶(APTT)、凝血酶时间(TT)的检测,应用连续无创血流动力学监测仪(CNAP)连续测定连续心排量(CO)、每搏输出量(SV)、平均动脉压(MAP)、心率(HR)、脉压差变异率(PPV)、血管外周阻力指数(SVRI),应用脉氧监测仪测得指脉氧(SPO₂),用旁流暗视野成像(SDF)监测技术观察舌下微循环指标:总血管密度(TVD)、灌注血管密度(PVD)、灌注血管比例(PPV)、微血管流动指数(MFI)。结果: 与上海组比较,互助组和果洛组的RBC、HGB明显升高(P＜0.05),而PLT明显降低(P＜0.05);互助组的PT、Fib、APTT、TT、CO、HR、SV、MAP、SPO₂均明显降低(P＜0.05),而TVD、PVD、PPV、MFI均明显升高(P＜0.05);果洛组的HCT、 Fib、CO、SV、PPV、MAP、TVD、PVD均明显升高(P＜0.05),而PT、INR、TT、SPO₂均明显降低(P＜ 0.05)。与互助组比较,果洛在组的RBC、HGB、HCT、 Fib、APTT均明显升高(P＜0.05);而SPO₂、TVD、PVD、INR、TT均明显降低(P＜0.05)。结论: 不同海拔地区的健康人微循环具有较明显的差异,高海拔地区健康人群微循环密度较平原地区明显增加,特别是在中度海拔地区更为明显,其特殊的生理意义,对救治高原地区感染性休克及慢性高原病有指导意义。     

SARS-CoV-2病毒感染潜在关键分子生物标志物及免疫浸润特征分析

应用生物信息学方法筛选新型冠状病毒肺炎（corona virus disease 2019,COVID-19）感染的潜在关键分子生物标志物并分析其免疫浸润特征。从GEO数据库下载GSE152418数据集,其中COVID-19患者17例,健康对照17例。用加权基因共表达网络分析（weighted gene co-expression network analysis,WGCNA）方法筛选出COVID-19最相关的模块基因。与差异基因取交集得到共同基因,进行功能及信号通路富集分析,构建蛋白互作网络筛选关键基因,构建关键基因的miRNATF-mRNA调控网络,用CIBERSORT算法预测样本免疫细胞浸润特征。差异分析得到2 049个差异基因。WGCNA分析7个模块中“土耳其蓝色”模块与COVID-19相关性最高（r=0.91,P<0.001）。模块中基因显著性和模块隶属度呈显著正相关（r=0.96,P<0.001）。得到共同基因766个,主要参与有丝分裂、微管结合、阳离子通道活性及卵母细胞减数分裂、细胞衰老等。蛋白互作网络筛选到前10位关键基因分别为CDK1、BUB1、CCNA2...     

人参归脾丸对脾不统血证大鼠肝损伤的保护作用及其机制*

目的:观察人参归脾丸对脾不统血证大鼠的治疗作用及其对肝脏的影响。方法:40只SPF级雄性SD大鼠随机分为正常对照组(n=10)和实验组(n=30),前42 d,实验组每日游泳30 min,同时饮食一天禁食两天(饮食失节),第43～72日,在游泳力竭加饮食失节的基础上,每日皮下注射低分子肝素钙诱导出血,构建脾不统血证大鼠模型;将成功建立模型的30只大鼠随机分为3组(n=10):模型对照组(MD)、自然复健组(NR)、归脾丸组(GP)。第73～102日,模型组继续施加处理因素(游泳力竭、饮食失节及注射低分子肝素钙溶液),自然复健组和归脾丸组停止施加处理因素,归脾丸组每日灌胃人参归脾丸溶液(0.2 g/ml ,10 ml/(kg·d)),自然复健组灌胃等量生理盐水;第103日后,取血和肝脏,检测血清中各组大鼠丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)、总蛋白(TP)水平,检测血中红细胞(RBC)数量、血红蛋白(HGB)含量和红细胞压积(HCT),ELISA试剂盒检测大鼠血清中 IL-6和TNF-α 含量,Western blot检测各组大鼠肝组织细胞凋亡相关蛋白Bcl-2、Bax、Caspase3蛋白水平,荧光定量PCR法检测大鼠肝组织细胞凋亡相关蛋白Bcl-2、Bax、Caspase3 mRNA表达水平。结果:与正常对照组相比,模型组大鼠血清ALT、AST和TBil水平均显著升高,TP水平明显降低(P＜ 0.01),血RBC数量、HGB含量和HCT均明显降低(P＜0.01),血清IL-6和TNF-α含量均显著升高(P＜0.05),肝组织Bcl-2 蛋白及mRNA水平均明显降低、Bax和Caspase3 蛋白及mRNA水平均显著升高(P＜0.01);与模型组相比,自然复健组和归脾丸组大鼠血清ALT、AST和TBil水平均明显降低,TP水平显著升高(P＜0.01),血RBC数量、HGB含量和HCT均明显升高(P＜0.01),血清IL-6和TNF-α含量均明显降低(P＜0.05),Bcl-2 蛋白及mRNA水平升高,Bax和Caspase3 蛋白及mRNA 水平降低(P＜0.05);与自然复健组相比,归脾丸组血清ALT、AST和TBil均明显降低,TP含量明显升高(P＜0.01),血RBC数量明显升高(P＜0.05),肝脏Bcl-2蛋白和mRNA水平显著升高(P＜ 0.05),Caspase3蛋白水平明显降低(P＜0.05),Bax mRNA表达显著降低(P＜0.05)。结论:人参归脾丸对脾不统血证大鼠肝损伤具有保护作用,其机制可能与其抑制肝脏细胞凋亡、促炎细胞因子释放有关。     

B-GOS对阿尔茨海默病转基因小鼠认知行为和抑郁情绪的影响*

目的: 观察新型低聚半乳糖(B-GOS)对APP/PS1/tau阿尔茨海默病转基因小鼠认知行为和抑郁情绪的影响。方法: 选用5月龄雄性APP/PS1/tau AD转基因小鼠和C57BL/6J对照小鼠,分为C57+Vehicle组、C57+B-GOS组、APP/PS1/tau+Vehicle组和APP/PS1/tau+B-GOS组,每组10只。B-GOS连续给予5个月后,依次采用旷场实验、新物体识别实验、Y迷宫实验、Morris水迷宫实验、悬尾实验、强迫游泳实验和条件恐惧实验,检测各组小鼠的认知行为表现和抑郁情绪变化。结果: ① 旷场实验:APP/PS1/tau+Vehicle组小鼠在旷场中央区域的活动时间百分比显著低于C57+Vehicle组小鼠(P＜0.01),经过B-GOS干预后显著升高(P＜0.05)。② 新物体识别实验:APP/PS1/tau+Vehicle组小鼠的新物体识别指数(NOI)显著低于C57+Vehicle组小鼠(P＜0.01), 经过B-GOS干预后显著升高(P＜0.05)。③ Y迷宫实验:APP/PS1/tau+Vehicle组小鼠的自发交替正确率显著低于C57+Vehicle组小鼠(P＜0.01),经过B-GOS干预后显著升高(P＜0.01)。④ 经典水迷宫实验:APP/PS1/tau+Vehicle组小鼠在第4日和第5日的逃避潜伏期显著长于C57+Vehicle组小鼠(P＜0.01),经过B-GOS干预后均显著缩短(P＜0.05);在空间探索阶段,APP/PS1/tau+Vehicle组小鼠的目标象限游泳时间百分比和穿越平台次数均显著低于C57+Vehicle组小鼠(P＜0.01),经过B-GOS干预后均显著增加(P＜0.01)。⑤ 悬尾试验和强迫游泳实验:APP/PS1/tau+Vehicle组小鼠的不动时间百分比均显著高于C57+Vehicle组小鼠(P＜0.01),经过B-GOS干预后均显著降低(P＜0.01)。⑥ 条件恐惧实验:在条件刺激(CS)作用前,各组小鼠的僵直比率无统计学差异(P＞0.05)。CS作用后,APP/PS1/tau+Vehicle组小鼠的僵直比率显著低于C57+Vehicle 组小鼠(P＜0.01),经过B-GOS干预后均显著上升(P＜0.01)。结论: B-GOS能够较大程度地逆转APP/PS1/tau小鼠的认知行为损伤,并减轻其抑郁情绪。     

瘦素对糖尿病大鼠糖脂代谢及炎性因子的影响

目的: 探讨瘦素对糖尿病大鼠糖脂代谢及相关炎症因子的影响。方法: 将健康Wistar雄性大鼠60只随机选取10只作为对照组,50只给予高糖高脂饲料喂养加腹腔内注射链脲佐霉素(STZ,25 mg/kg)的方法诱发并建立糖尿病大鼠模型。并随机分为模型组、瘦素低剂量组、瘦素中剂量组和瘦素高剂量组,每组10只。4组大鼠造模成功后均持续给予高糖高脂饲料喂养,瘦素低、中、高剂量组给予20 μg/kg、50 μg/kg和100 μg/kg,连续5 d。GOD-PAP法检测大鼠血糖(FBG),放射免疫法测定胰岛素含量(Ins),全自动生化分析仪测定血清中三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)。采用酶联免疫方法(ELISA)测定丙二醛(MDA)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)。采用Western blot检测糖尿病大鼠脂肪组织中瘦素表达情况。结果: 与对照组比较,各组大鼠血糖水平均显著升高(P＜0.01);与模型组比较,瘦素中、高剂量大鼠血糖显著降低(P＜0.05,P＜0.01);瘦素高剂量组胰岛素水平显著降低(P＜0.01)。不同剂量瘦素组间比较,给药后三组大鼠FBG及INS无统计学差异(P＞0.05)。与模型组比较,瘦素中、高剂量组TC水平显著下降(P＜0.05,P＜0.01);高剂量组TG、LDL-C水平显著降低(P＜0.05),高剂量组HDL-C水平显著升高(P＜0.01)。不同剂量瘦素组进行组间比较,高剂量组在降低TC、TG、LDL-C水平,升高HDL-C水平优于中、低剂量组(P＜0.05)。Western blot结果显示,与模型组(52.27±10.93)比,瘦素高剂量组100 μg/kg(40.13±9.87)、中剂量组50 μg/kg(44.68±10.23)、低剂量组20 μg/kg(47.35±12.09)脂肪中瘦素表达水平依次降低。结论: 瘦素水平分泌异常是诱发糖尿病因素之一,在给予一定浓度外源性瘦素(100 μg/kg)干预下,能显著降低MDA、TNF-α水平,提高IL-6水平,其机制可能与瘦素在减轻炎症反应、氧化应激,纠正血脂异常紊乱有密切关系。     

辣木叶对糖尿病大鼠认知功能及海马神经细胞凋亡的影响*

目的:探讨辣木叶对链脲佐菌素(STZ)诱导的糖尿病模型大鼠认知功能障碍及海马神经细胞凋亡的影响。方法:选取健康SD雄性大鼠50只,随机选取10只作为对照组,40只大鼠给予腹腔注射25 mg/kg STZ构建糖尿病大鼠模型。40只大鼠随机分为模型组、辣木高、中、低剂量组,分别每日灌胃给药2.0 g/kg、4.0 g/kg、8.0 g/kg辣木叶,对照组和模型组每日灌胃给药等量生理盐水,1次/日,持续给药8周。Morris水迷宫实验评价大鼠学习记忆能力;HE染色及免疫组化染色对大鼠海马神经元切片进行染色,观察各组大鼠海马神经元病理改变的情况及Bax、caspase-3及Bcl-2蛋白表达情况;酶联免疫法(ELISA)检测大鼠海马组织中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)。结果:与对照组相比,模型组大鼠血糖值明显提高(P＜0.01),血胰岛素水平明显降低(P＜0.05);与模型组相比,辣木组血糖值显著降低(P＜0.05,P＜0.01),辣木中、高剂量组血胰岛素水平显著升高(P＜0.05,P＜0.01)。不同剂量组辣木组间比较,给药后3组大鼠FBG及INS无统计学差异(P＞0.05);Morris水迷宫实验的第4-5日,与模型组相比较,辣木各剂量组潜伏期均明显缩短(P＜0.05);辣木不同剂量组目标象限停留时间明显延长(P＜0.05)。炎症因子变化结果,与模型组相比较,辣木低、中、高剂量组TNF-α、IL-6含量及蛋白表达水平显著降低(P＜0.05)。HE染色及免疫组化染色结果显示,与模型组相比较,辣木中剂量组中阳性表达,呈棕黄色,细颗粒状。辣木叶中剂量组(53.21±7.19)能显著减少神经元细胞凋亡的数目(P＜0.01);辣木组中剂量组大鼠海马组织中Bax、caspase-3的蛋白表达及Bax/Bcl-2比例显著降低(P＜0.05)。结论:辣木叶能改善糖尿病大鼠认知功能障碍其作用机制可能与调节Bax、Bcl-2、caspase-3的蛋白表达,降低炎症因子TNF-α及IL-6含量相关。