铬对克山病病区粮所致大鼠心肌损伤保护机理探讨

目的研究铬对克山病病区粮所致大鼠心肌损伤保护作用,探讨其保护机理.方法克山病病区粮喂养Wistar大鼠复制低硒动物模型,加铬加硒作为干预因素.观察生长发育状况;描计心电图;玻璃微电极法删心肌细胞电生理;荧光偏振法测心肌细胞线粒体膜流动性;低温顺磁共振技术测定心、肝自由基含量;生化法测血、心、肝GSH-Px及SOD活性;放射免疫法测心肌环磷酸腺苷和甲状腺激素;透射电镜观察心肌超微结构变化.结果低硒饲料喂养动物生长延迟;心电图及心肌电生理QRS时限、Q-T间期及APD50、APD90延长;心肌细胞膜流动性降低;心肝自由基水平升高、抗氧化酶类GSH-Px及SOD活性降低;甲状腺激素T3、T4及心肌cAMP降低;心肌超微结构显示心肌损伤.铬则可改善低硒动物营养状况,恢复心肌组织生理病理学变化.结论铬对低硒状态所致心肌损伤具有保护作用,逆转QRS时限、Q-T间期和APD的改变;提高心肌细胞膜流动性;增强抗氧化酶活性,降低自由基水平及调整甲状腺激素和心肌cAMP代谢则是铬抗低硒心肌损伤的重要作用机制.     

铬对心肌的生物学作用及对心肌损伤的保护机理

采用多学科技术就铬的机体分布及其对代谢的影响、对心肌细胞的生物学作用、对心肌损伤的保护作用及机理进行了系统深入的研究，为铬在生物体内的分布和代谢研究提供了动物实验数据；揭示铬对动物心肌细胞和浦肯野纤维的生物学作用，为抗心律失常、实验性心肌病的研究提供了心肌电生理基础；证实铬对实验性心肌损伤具有保护作用，增强抗氧化功能、改善心肌细胞膜流动性、调整甲状腺激素和心肌环核苷酸代谢紊乱、维持心肌细胞生长是铬抗心肌损伤的重要机制。     

低硒与大鼠心肌组织脂质过氧化及心肌细胞损伤的关系

目的 :观察低硒喂养对大鼠心肌组织脂质过氧化物、心肌细胞超微结构及细胞凋亡的影响。方法 :将SD大鼠分为低硒饲料喂养及低硒饲料加硒喂养两组 ,至 12周时测血硒、谷胱甘肽过氧化物酶 （GPX）、心肌组织匀浆丙二醛 （MDA）水平 ,行心肌组织超微结构电镜观察及心肌细胞凋亡检测。结果 :低硒喂养组大鼠血硒及GPX水平较加硒喂养组显著为低 ,心肌组织匀浆MDA水平显著升高 ,心肌细胞线粒体肿胀增大 ,线粒体嵴排列紊乱 ,部分嵴溶解 ,部分线粒体空泡变 ,心肌细胞凋亡发生率显著升高。结论 :低硒可致心肌过氧化物损伤、心肌细胞线粒体损伤及细胞凋亡。     

T-2毒素致大鼠心肌损伤的实验研究

目的 对低硒条件下,T-2毒素损伤大鼠心肌的机制进行实验研究,探讨克山病的发病原因。方法 采用低硒饲料喂养大鼠,用T-2毒素亚急性损伤心肌的动物模型,应用原位末端标记法和免疫组化技术检测大鼠心肌细胞凋亡和检测心肌中谷胱甘肽过氧化物酶（GSH-Px）活性。结果 低硒加T-2毒素组大鼠心肌损伤较重,凋亡细胞检出较多,常硒饲料加T-2毒素与低硒饲料加T-2毒素组均可见心肌坏死;这2个组心肌组织GSH-Px活性降低,心肌中可检出凋亡细胞;而后者损伤严重。结论 T-2毒素可使大鼠心肌损伤,在低硒条件下,这种损伤加重。低硒条件下,T-2毒素损伤大鼠心肌的机制与脂质过氧化和细胞凋亡有关。     

克山病病区粮喂养大鼠心肌细胞膜流动性及膜结合酶活性的研究

本文对比观察了低硒的克山病病区粮和补硒的克山病病区粮喂养大鼠其心肌细胞膜流动性及膜结合酶Na~+—K~+—ATP酶、5′—核苷酸酶活性的变化。实验结果表明,克山病病区粮喂养的大鼠心肌细胞膜流动性及膜结合酶活性均降低;给病区粮补硒0.25ppm后可使上述心肌细胞膜的异常变化得到一定的恢复,据此认为细胞膜流动性异常可能是低硒对膜结合酶影响的中间环节。是低硒导致细胞膜功能障碍的基础。     

硒对氟致机体损伤保护作用的实验研究

目的 研究硒对氟致机体损伤的保护作用及探讨其保护机理。方法 Wistar大鼠饮30mg／L和50mg／L高氟水造成慢性氟中毒，同时另外两组大鼠饮高氟水、饲2mg／kg加硒饲料。1年内每月测饮水摄食和排尿量，测尿氟含量；每2月摄X线片。喂养4、8、14个月分批处死大鼠，测硒氟含量、骨形态计量学参数、自由基含量、抗氧化酶类、甲状腺激素、心电图、心肌电生理参数等。结果 对氟中毒大鼠投硒可改善饮食、增加体重；促进尿氟排泄，降低体氟；延迟X线异常改变和氟骨症的发生同时减少骨量对骨矿化障碍产生抑制作用；恢复抗氧化酶类活性；调整甲状腺激素水平；拮抗氟中毒所致的心电图和心肌电生理异常。结论 一定浓度范围内的硒具有拮抗高氟作用，促进尿氟排泄、保护骨骼系统、调整自由基代谢及对肝、肾、心脏的作用是硒拮抗高氟的重要机制。     

低硒致乳鼠心肌细胞凋亡的实验研究

目的　为进一步探讨低硒与心肌损伤的关系,以及细胞凋亡是否参与心肌损伤及其机制。方法　用低硒合成饲料喂养昆明鼠,五周后交配,取其子代 ３ 周龄乳鼠心肌组织,采用ＴＵＮＥＬ法、透射电镜及免疫组化法等技术检测凋亡细胞及其相关基因。结果　低硒乳鼠心肌细胞有凋亡现象存在,而补硒组却未见类似现象。结论　低硒可以引起子代乳鼠心肌细胞发生凋亡     

克山病区低硒粮饲养大鼠的心肌细胞超微结构及膜通透性改变的实验观察

本实验用克山病区低硒粮喂养大鼠,使动物处于低硒状态,同时增设补硒组和常规饲料组作为对照。饲养二个月后,应用电镜和示踪剂分别观察其心肌细胞超微结构及膜通透性的改变。低硒组大鼠心肌细胞膜不完整,镧颗粒进入细胞内,但线粒体内罕见。质膜经钌红染色呈中等电子密度的不均匀窄带,并经质膜破损处进入心肌细胞内。实验结果表明,低硒可引起大鼠早期心肌细胞超微结构及膜通透性的改变。     

心肌细胞膜脂流动性与超微结构研究

本研究应用荧光分光光度计偏振技术研究犬实验性急性心肌梗塞早期时心肌细胞膜流动性及超微结构改变的相关程度.结果表明,冠状动脉左前降支阻断后,心肌细胞膜脂流动性明显降低,阻断前为40.952±4.623,阻断1分钟为31.936±4.008.随着缺血时间延长,,心肌细胞膜脂流动性降低越明显,阻断15和120分钟时,膜脂流动性分别为27.164±4.204和26.572±3.126(与阻断前比较,P<0.05),阻断240分钟时膜脂流动性为23.374±2.604(P<0.01,与阻断前比较).而在电镜下则见心肌组织学损坏进行性加重,因此,心肌细胞膜脂流动性的降低程度与心肌缺血时间长短和损伤程度密切相关,并与心肌组织超微结构改变相一致,是反映心肌细胞缺血损伤的一个敏感指标.     

铬对实验性心肌损伤保护机制探讨

为探讨铬对实验性心肌损伤的保护作用机制，选用Ｗｉｓｔａｒ大鼠腹腔内注射铬，尾静脉注射阿霉素，复制动物模型，用荧光偏振法测定心肌线粒体膜流动性，低温电子自旋共振技术测定心肌及肝脏自由基含量，同时观察抗氧化酶及心肌酶活性变化。结果表明单纯注射阿霉素大鼠心肌线粒体膜流动性降低，血清ＬＤＨ及ＣＰＫ活性增强，心肌及肝脏自由基含量升高，全血、心肌及肝脏ＧＳＨ－ｐｘ活性降低，血清ＳＯＤ活性增强，心肌及肝脏ＳＯＤ     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

CagA-Hp抗体IgG与胃炎的组织学分析

研究幽门螺杆菌(Hp)感染与胃炎的关系。方法对204例慢性胃炎患者胃粘膜进行观察分析,并测定其中137例Hp阳性患者血清CagA-Hp抗体IgG水平,与组织学对照。结果慢性萎缩性胃炎伴肠上皮化生患者血清CagA抗体IgG明显高于对照组(P＜0.01);其他类型胃炎患者血清CagA抗体IgG水平无明显增高(P＞0.05)。结论CagA-Hp可能是导致慢性萎缩性胃炎伴肠上皮化生的因素之一,对这类患者应密切随访观察。     

慢阻肺急性加重期患者预后的影响因素分析

目的探讨慢性阻塞性肺病急性加重期(AECOPD)患者预后的相关危险因素。方法回顾性调查、收集58例AECOPD患者可能影响其预后的相关因素,并对其分别进行单因素分析。并进行Logistic多元逐步回归进行多因素分析,筛选影响AECOPD患者预后的独立危险因素。结果单因素分析后将结果 P0.1的因素纳入多因素Logistic回归,分析发现是否合并呼吸衰竭、气促程度、白细胞计数、APACHEⅡ、应用抗氧化剂、慢阻肺治疗依从性为影响AECOPD患者预后不佳的独立因素(P0.05)。结论根据AECOPD患者预后的独立危险因素,及早判断,选择合适的后续治疗方案,对提高其生存率及生存质量具有重要意义。