慢性肾脏病并发左室肥厚现况及其危险因素

目的：探索中老年慢性肾脏病并发左室肥厚（LVH）的现况及其危险因素。方法：对我院肾内科住院的40-75岁CKD2-5期患者210例的病历资料进行回顾性分析。结果：（1）心脏舒张功能减退发生率高于收缩功能减退（79.1%VS 20.3%P=0.000）;左房扩大检出率高于左室扩大检出率（46.5%VS 19.8%P=0.000）;室间隔增厚检出率（IVSH）也高于左室后壁增厚检出率（LVPWH）（43.0%VS 21.1%P=0.000）;LVH的发生率高于IVSH检出率（47.9%VS 35%P=0.001）,其中女性LVH高于男性（73.2%VS31.0%P=0.000）,然而若采用另外一种诊断标准,两者并无统计学差异（50%VS 34.5%P=0.068）。（2）IVSH组收缩压、脉压、血肌酐均高于无IVSH组。IVSH组除上述因素外血磷尚高于无IVSH组,但在CKD5期的亚组分析中仅收缩压与对照组相比有统计学差异。LVH组收缩压、脉压均高于无LVH组,而血红蛋白、体质指数则低于对照组。进一步Logistic回归分析提示仅性别、体质指数有统计学意义。结论：（1）40-75岁的心血管疾病高危的CKD患者中,采用超声心动图诊断LVH,根据公式计算的LVMI诊断阳性率最高,但诊断切点仍需进一步研究。（2）收缩压升高、脉压增大、贫血、低体质指数、女性均可能是LVH的危险因素,控制血压、纠正贫血和营养不良可能是防治LVH的重要靶点。     

Increased insulin-like growth factor-I gene expression precedes left ventricular cardiomyocyte hypertrophy in a rapidly-hypertrophying rat model system

Chronic pressure overload leads to an increase in the size, i.e. hypertrophy, of cardiomyocytes in the heart. However, the molecular mechanisms underlying this hypertrophy are not understood. Insulin-like growth factor-I (IGF-I) synthesized locally in the heart is known to be associated with the hypertrophic process. So far, however, cardiac IGF-I gene expression in the widely used rat model system has only been shown to be increased when the hypertrophy induced by pressure-overload was already established. Therefore, the question of whether IGF-I serves as an initiating or early-enhancing factor for the cardiac hypertrophy remains unanswered. Here, cardiac hypertension and hypertrophy were rapidly induced in the rat by complete constriction of the abdominal aorta between the origins of the renal arteries. Carotid arterial systolic blood pressure remained unchanged in sham rats but increased rapidly in the pressure-overloaded constricted rats with a sustained hypertension established by 3 days. Hypertrophy of left ventricular (LV) cardiomyocytes in constricted rats also occurred by 3 days. However, this hypertrophy was preceded by increases in LV IGF-I mRNA and protein which occurred within 1 day. These results support the hypothesis that cardiac-synthesized IGF-I is an initiating or early-enhancing factor for hypertrophy of LV cardiomyocytes.     

Serum supplemented culture medium masks hypertrophic phenotypes in human pluripotent stem cell derived cardiomyocytes

It has been known for over 20 years that foetal calf serum can induce hypertrophy in cultured cardiomyocytes but this is rarely considered when examining cardiomyocytes derived from pluripotent stem cells (PSC). Here, we determined how serum affected cardiomyocytes from human embryonic‐ (hESC) and induced pluripotent stem cells (hiPSC) and hiPSC from patients with hypertrophic cardiomyopathy linked to a mutation in the MYBPC3 gene. We first confirmed previously published hypertrophic effects of serum on cultured neonatal rat cardiomyocytes demonstrated as increased cell surface area and beating frequency. We then found that serum increased the cell surface area of hESC‐ and hiPSC‐derived cardiomyocytes and their spontaneous contraction rate. Phenylephrine, which normally induces cardiac hypertrophy, had no additional effects under serum conditions. Likewise, hiPSC‐derived cardiomyocytes from three MYBPC3 patients which had a greater surface area than controls in the absence of serum as predicted by their genotype, did not show this difference in the presence of serum. Serum can thus alter the phenotype of human PSC derived cardiomyocytes under otherwise defined conditions such that the effects of hypertrophic drugs and gene mutations are underestimated. It is therefore pertinent to examine cardiac phenotypes in culture media without or in low concentrations of serum.     

Morphological and plant hormonal changes during parasitization by Cuscuta japonica on Momordica charantia

The holostemparasitic plant Cuscuta parasitizes various plants and sucks nutrients from the host stem. We used Cuscuta japonica as the parasite and Momordica charantia as the host plant, and described their interaction. The parasitized Momordica stems started swelling as a hypertrophic response within 3 days after parasitization. Concurrently, the Cuscuta stem grew rapidly and developed bigger scale leaves than usual. Parasitized Momordica stems reduced photosynthetic activity. Histological observation revealed no programmed cell death but an increased number of vascular bundles in the Momordica stem, especially near the Cuscuta hyphae. The defensive response of Momordica mainly involved the SA pathway. Drastic increase of tZ- and DZ-type cytokinins in Momordica stems would play an important role for hypertrophy. Cuscuta had higher cZ endogenously and our results imply that each subtype of CK might play different roles during parasitization process. Comprehensive plant hormone analysis provides new insights into plant interaction studies.     

A novel cell-based system for evaluating skeletal muscle cell hypertrophy-inducing agents

Skeletal muscle is a tissue that adapts to increased use by increasing contractile protein gene expression and ultimately skeletal muscle mass (hypertrophy). To identify hypertrophy-inducing agents that may be potentially useful in the treatment of age-related muscle loss (sarcopenia) and to better understand hypertrophy signal transduction pathways, we have created a skeletal muscle cell-based hypertrophy-responsive system. This system was created by permanently modifying the relatively undifferentiated C2C12 cell line so that it contains the beta-myosin heavy chain (beta-MHC) gene promoter and enhancer regions fused to a luciferase reporter gene. This cell line responds, by increasing luciferase expression, to a variety of skeletal muscle hypertrophy-inducing agents, including insulin, insulin-like growth factor I, testosterone, and the beta-adrenergic receptor agonist isoproterenol, in both the undifferentiated and differentiated states. This cell-based system should be useful for identifying novel hypertrophy-inducing agents as well as understanding hypertrophy signal transduction.     

依那普利叶酸片对高血压伴高同型半胱氨酸血症大鼠左室肥厚干预的研究

目的:观察高同型半胱氨酸对高血压大鼠心肌内质网应激相关因子GRP94、caspase12表达的影响,及依那普利叶酸片(简称依叶片)对其表达的干预作用。方法:30只雄性成年自发性高血压大鼠(SHR),随机分为对照组、模型组和依叶片组,每组10只。对照组给予普通颗粒饲料喂养同时给予双蒸水灌胃,模型组给予含3%蛋氨酸的颗粒饲料喂养同时给予双蒸水灌胃,依叶片组给予含3%蛋氨酸的颗粒饲料喂养同时给予依叶片粉剂20 mg/kg/d灌胃。实验第8周末,用颈动脉插管法测各组大鼠平均动脉压(MAP),同型半胱氨酸检测仪检测血清同型半胱氨酸(homocystein,Hcy)浓度,称取体质量、全心质量及左心室质量计算大鼠心肌肥厚指数HWI及LVEI,通过HE染色观察心肌细胞形态学改变,免疫组化检测大鼠心肌组织中GRP94及caspase12表达水平。结果:①大鼠血清Hcy水平的变化。对照组大鼠血清Hcy值在正常值范围。与对照组相比,模型组大鼠血清Hcy值显著增高(P0.01);与模型组相比,依叶片组大鼠血清Hcy值明显降低(P0.01)。②大鼠HWI、LVEI及MAP的变化。模型组大鼠的HWI及LVEI均明显高于对照组(P0.05);依叶片干预后大鼠的HWI及LVEI均明显降低(P0.05)。对照组与模型组大鼠的MAP均明显增高,但两组大鼠的MAP差异无统计学意义(P0.05);与模型组相比,依叶片干预后大鼠的MAP明显降低(P0.01)。③大鼠心肌细胞内质网应激(endoplasmic reticulum stress,ERS)相关因子GRP94及caspase12表达。对照组及模型组大鼠心肌细胞GRP94及caspase12表达均增高。与对照组相比,模型组大鼠心肌细胞GRP94、caspase12表达增高更为明显(P0.05)。依叶片干预后大鼠心肌细胞GRP94、caspase12表达明显降低(P0.05)。结论:高Hcy通过ERS途径使高血压大鼠左室肥厚程度加重;依叶片可有效降低血清Hcy及血压水平,抑制心肌细胞ERS,从而有效逆转左室肥厚,其对左室肥厚干预的分子机制为"H型"高血压的预防及治疗提供了新的理论依据。     

The effect of Meloidogyne incognita on the histopathology of Momordica charantia roots

Bitter gourd (Momordica charantia L.) was inoculated with root-knot nematode Meloidogyne incognita to investigate the anatomical abnormalities in the affected roots. Soon after inoculation the second-stage juveniles (J2) entered at or near the root caps and migrated intercellularly towards the zone of vascular differentiation. Discrete giant cells were observed after three days of inoculation. The nematode induced hypertrophy and hyperplasia near the giant cells. After six days, the juveniles moulted to their third stage (J3). At the same, time giant cell size and density of giant cell cytoplasm increased. The continuity of vascular strands remained unaffected. Between 12 and 24 days of inoculation the giant cells enlarged several times and became multinucleate and enclosed dense and granular cytoplasm. The nematodes became almost pyriform 18 days after inoculation. The orientation of vascular strands changed, due to hypertrophy, hyperplasia and enlargement of the nematode. After 30 days of inoculation the nematodes developed into mature females and started egg laying. A large amount of parenchyma transformed into abnormal xylem.