β-淀粉样蛋白致大鼠行为学改变及对海马核因子-κB和一氧化氮合酶表达的影响

目的研究β-淀粉样蛋白(amyloid-beta protein,Aβ)对大鼠学习记忆功能及海马区内核因子kB(NF-kB)、诱导型一氧化氮合酶(iNOS)蛋白表达的影响及其相互关系。探讨NF-kB在阿尔茨海默病(AD)发病中的可能作用。方法采用大鼠侧脑室立体定向注射Aβ25-35的方法建立AD的动物模型,通过Morris水迷宫检测大鼠学习、记忆能力,通过免疫组化的方法观察Aβ25-35对大鼠海马区内NF-kB及iNOS蛋白表达的影响,并分析NF-kB与iNOS表达的关系。结果大鼠经侧脑室立体定向注射10μmol／L Aβ25-35 5μl后,(1)模型组大鼠Morris水迷宫检测逃避潜伏期(3 d分别为42．19±12．29,31．28±20．59,23．91±8．05)较对照组(3 d分别为27．35±14．96,13．17±6．79,13．01±6．38)明显延长(P<0．05或P<0．01);(2)模型组大鼠海马区内NF-kB蛋白表达(29．40±4．01)及iNOS蛋白表达(34．42±5．99)较空白对照组(分别为23．36±2．31和11．56±4．09)均有明显升高(P<0．01),(3)NF-kB与iNOS阳性细胞密度具有显著相关性(r=0．453,P< 0．05)。结论Aβ能够明显降低大鼠短期学习记忆能力,并诱导大鼠海马区内NF-kB和iNOS的蛋白表达增强,同时NF-kB与iNOS的表达呈正相关关系。提示NF-kB和iNOS均参与了由Aβ诱导的炎性反应过程,NF-kB可能是iNOS表达的介导因子之一。     

川陈皮素对糖尿病大鼠认知功能障碍的影响

目的探讨川陈皮素(NOB)改善糖尿病认知功能障碍的作用及可能机制。方法 12周龄健康雄性SD大鼠40只,随机选取32只,腹腔注射1%链脲佐菌素(STZ)溶液建立糖尿病大鼠模型;余8只设为正常对照组给予等剂量缓冲液注射。造模成功后,随机分为糖尿病组(n=8),NOB高剂量组(n=6,30 mg/kg)、中剂量组(n=6,20 mg/kg)和低剂量组(n=6,10 mg/kg),阳性对照组即α-硫辛酸组(n=6,60 mg/kg)。正常对照组、糖尿病组均予腹腔注射等量生理盐水,1次/d,连续8 w。22周龄时行Morris水迷宫实验测试大鼠学习记忆能力及空间探索能力比较各组认知功能,采用Western印迹方法检测海马CA1区γ-谷氨酰半胱氨酸合成酶(GCS)、血红素氧合酶(HO)-1、Caspase-12的表达。结果与正常对照组比较,糖尿病组水迷宫实验中潜逃潜伏期明显延长(P0. 01)、在目标象限停留时间明显缩短(P0. 01),提示大鼠学习记忆的能力明显下降;糖尿病组海马CA1区γ-GCS、HO-1、Caspase-12表达量增加(P0. 01)。与糖尿病组比较,NOB治疗后各组潜逃潜伏期明显延长、在目标象限停留的时间明显缩短(P0. 01,P0. 05),海马CA1区γ-GCS、HO-1表达量增加(P0. 05,P0. 01)、Caspase-12表达量减少(P0. 05,P0. 01),以中、高剂量组效果显著,两组间比较差异无统计学意义(P0. 05)。结论 NOB能够通过上调海马CA1区γ-GCS、HO-1表达、减少Caspase-12蛋白表达,增强抗氧化应激和抑制凋亡而改善糖尿病大鼠的学习和记忆能力。     

糖尿病大鼠海马血管紧张素转化酶2表达与认知功能的相关性

目的观察糖尿病大鼠海马血管紧张素转化酶(ACE)2 mRNA和蛋白的表达并探讨其对糖尿病大鼠认知功能的影响。方法 20只雄性SD大鼠随机均分为正常对照组和糖尿病组,建立STZ糖尿病模型,建模成功后11 w用Morris水迷宫测试学习与记忆能力,RT-PCR检测海马ACE2 mRNA的表达,Western印迹检测海马(ACE)2蛋白表达。结果与正常对照组相比,糖尿病组大鼠学习与记忆能力明显减退,其逃避潜伏期时间延长(P<0.05),穿越目标区域次数减少(P<0.05);海马ACE2 mRNA和ACE2蛋白表达明显降低(P<0.05)。结论糖尿病大鼠海马(ACE)2 mRNA和蛋白表达下调与糖尿病大鼠认知功能障碍有关。     

银杏内酯B对阿尔茨海默病大鼠海马c-fos、Caspase-3和Caspase-8的影响

目的探讨银杏内酯B(GB)对阿尔茨海默病(AD)大鼠c-fos、Caspase-3和Caspase-8的影响。方法将大鼠随机分为正常组、假手术组、模型组和银杏内酯B组,采用Morris水迷宫检测学习记忆,免疫组织化学分析海马c-fos阳性神经元光密度值,荧光定量PCR和Western blot检测海马Caspase-3和Caspase-8的mRNA和蛋白水平。结果 5 mg/kg的银杏内酯B可缩短AD大鼠逃避潜伏期,增加穿越平台次数,提高海马c-fos的表达,下调凋亡相关基因Caspase-3和Caspase-8 mRNA和蛋白表达。结论银杏内酯B可改善AD大鼠学习记忆能力,这种改善可能与上调AD大鼠海马组织c-fos表达,下调Caspase-3和Caspase-8 mRNA和蛋白水平有关。     

TAT-XIAP融合蛋白对Aβ(25～35)诱导的阿尔茨海默病大鼠行为学的影响

目的 研究TAT-XIAP融合蛋白对阿尔茨海默病(AD)大鼠空间学习记忆能力的影响.方法 将SD大鼠随机分成三组,对照组海马区注射生理盐水,模型组海马区注射Aβ (25 ～35),给药组尾静脉注射TAT-MAP融合蛋白10 mg/kg.采用Morris水迷宫法检测AD大鼠的空间学习记忆能力.结果 与模型组比较,给药组AD大鼠的Morris水迷宫实验逃避潜伏期缩短(P＜0.05);游泳轨迹路线多在平台所在象限附近,呈趋向型.结论 TAT-XIAP融合蛋白能够改善AD大鼠空间学习记忆能力.     

血管紧张素Ⅳ对糖尿病大鼠胆碱乙酰转移酶表达及认知功能的影响

目的 观察血管紧张素Ⅳ(AngⅣ)对糖尿病大鼠海马胆碱乙酰转移酶(ChAT)表达及认知功能的影响.方法 38只SD大鼠随机分为正常对照组、糖尿病组和糖尿病+AngⅣ组,建立STZ糖尿病大鼠模型, Morris水迷宫测试大鼠学习和记忆能力,免疫组化观察大鼠海马ChAT的表达,RT-PCR检测ChAT mRNA水平的表达.结果 糖尿病+ AngⅣ组海马chAT及其mRNA表达与糖尿病组相比明显增高(P<0.05),糖尿病+ AngⅣ组大鼠学习和记忆成绩也明显优于糖尿病组(P<0.05).结论 AngⅣ对糖尿病大鼠认知功能有改善作用,其机制可能与ChAT表达增加有关.     

Morris水迷宫训练对老年痴呆大鼠模型学习记忆能力及海马组织肿瘤坏死因子-α、超氧化物歧化酶、丙二醛水平的影响

目的观察Morris水迷宫训练对老年痴呆(AD)大鼠学习记忆能力及海马组织肿瘤坏死因子(TNF)-α、超氧化物歧化酶(SOD)、丙二醛(MDA)的影响。方法随机将32只SD雄性大鼠分为假手术组、模型组、Morris水迷宫短期训练组和Morris水迷宫长期训练组;以穹隆-海马伞切断建立痴呆大鼠模型;运用Morris水迷宫进行训练;采用跳台实验以及水迷宫实验测试大鼠的学习和记忆能力;采用酶联免疫吸附法(ELISA)测定大鼠海马组织TNF-α的水平,比色法检测大鼠海马组织SOD活性和MDA含量。结果 Morris水迷宫训练后AD大鼠学习记忆能力显著提高(P<0.01);大鼠海马区TNF-α、MDA含量明显降低(P<0.05)、SOD含量明显升高(P<0.05)。结论 Morris水迷宫训练能明显改善大鼠的学习记忆能力,其机制可能与提高海马区SOD含量、降低TNF-α和MDA水平有关,而且水迷宫训练时间越长,恢复越明显。     

归芪聪志汤对血管性痴呆大鼠海马缺氧诱导因子-1α、血管内皮生长因子和血红素加氧酶-1表达的影响

目的研究归芪聪志汤对血管性痴呆(VD)大鼠海马缺氧诱导因子(HIF)-1α、血管内皮生长因子(VEGF)及血红素加氧酶(HO-1)表达的影响。方法采用改良后的双侧颈动脉永久性结扎法制备VD大鼠模型,将80只大鼠随机分为6组:假手术组、模型组、阳性对照组、归芪聪志汤高、中、低剂量组。连续灌胃4 w后采用Morris水迷宫进行行为学检测,同时通过HE染色观察海马神经元的形态改变,采用免疫组织化学法测定各组海马组织HIF-1α、VEGF及HO-1蛋白的表达水平,采用荧光定量PCR技术检测大鼠海马HIF-1α、VEGF及HO-1 mRNA表达的变化。结果经过治疗后,与假手术组比较,模型组大鼠的平均逃避潜伏期明显延长、跨原平台次数明显减少,差异有统计学意义(P0.05),大鼠海马HIF-1α、VEGF及HO-1蛋白及mRNA表达水平明显升高,差异有统计学意义(P0.05),HE染色显示大鼠海马神经细胞损伤严重;与模型组比较,归芪聪志汤中剂量组与阳性对照组大鼠的逃避潜伏期均显著缩短、跨原平台次数均显著增加,差异有统计学意义(P0.05),大鼠海马HIF-1α、VEGF及HO-1蛋白及mRNA表达水平均显著升高,差异有统计学意义(P0.05),HE染色显示大鼠海马神经细胞损伤减轻。结论归芪聪志汤能明显改善VD模型大鼠的学习记忆能力,其作用机制可能与上调HIF-1α、VEGF及HO-1的表达,减轻氧化应激损伤,激发脑内的损伤修复有关。     

罗格列酮对糖尿病大鼠心肌基质金属蛋白酶2表达的影响

目的观察罗格列酮对2型糖尿病大鼠心肌基质金属蛋白酶2(MMP-2)的影响。方法42只W istar大鼠随机分成正常对照组(n=6)和糖尿病组(n=36),糖尿病组以小剂量链脲佐菌素(25 mg/kg)腹腔注射的方法建立2型糖尿病大鼠模型。糖尿病组再随机分为罗格列酮组、格列齐特组和糖尿病对照组,分别应用罗格列酮(2 mg/kg)、格列齐特(25 mg/kg)和淀粉治疗,疗程12 w。应用透射电镜评价各组心肌超微结构,应用免疫组化方法和RT-PCR方法分别检测心肌MMP-2蛋白和mRNA表达水平。结果糖尿病组心肌出现明显的心肌重构,罗格列酮组病变较糖尿病对照组轻。糖尿病对照组心肌MMP-2蛋白和mRNA水平明显高于正常组大鼠〔(0.47±0.03)vs(0.17±0.02)和(1.14±0.09)vs(0.46±0.05),均P<0.01〕;罗格列酮组心肌MMP-2蛋白和mRNA水平明显低于糖尿病对照组〔(0.26±0.03)vs(0.47±0.03)和(0.72±0.08)vs(1.14±0.09),均P<0.05〕。结论罗格列酮能够明显改善糖尿病大鼠早期心肌重构,机制可能与抑制心肌MMP-2的表达有关。     

促红细胞生成素对慢性脑缺血大鼠认知障碍及海马星形胶质细胞的影响

目的 观察促红细胞生成素干预后慢性脑缺血大鼠的空间学习记忆功能及海马星形胶质细胞的变化.方法 结扎大鼠双侧颈总动脉建立慢性脑缺血模型,治疗组术后给予EP01 000 U/kg腹腔内注射5d.术后第8周时3组大鼠Morris水迷宫测试后断头取脑做免疫组化检测观察CA1区胶质纤维酸性蛋白(GFAP)表达.结果 缺血组水迷宫表现同假手术组和EPO治疗组相比有显著差异(P＜0.01).EPO干预能改善慢性脑缺血大鼠的空间学习记忆能力(P＜0.01).缺血组海马CA1区GFAP表达较假手术组相比明显增多,而EPO组海马CA1区GFAP表达同缺血组相比明显降低(P＜0.01).海马CA1区GFAP阳性细胞数与学习记忆能力呈负相关.结论 EPO能显著改善慢性脑缺血大鼠认知障碍,机制可能与减少海马星形胶质细胞增生有关.     

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。