益气活血方药抗大鼠肝纤维化作用的实验研究

目的:研究益气活血方药抗大鼠实验性肝纤维化的效应及作用机制。方法:60只雄性Wistar大鼠被分为6组(正常对照组、阴性药对照组、阳性药对照组、大剂量组、中剂量组、小剂量组),猪血清腹腔注射复制动物模型,用益气活血药物治疗7W后,处死动物,取材。Mallory染色,经图像分析仪处理,观察肝脏胶原纤维生成量。分离鼠肝星状细胞(HSC),体外培养,用内毒素(lipopolysaccharide,LPS)刺激其增殖,MTT法测定细胞增殖及含药血清对其增殖的抑制作用。结果:益气活血药物有明显的抗肝纤维化作用。小剂量组肝胶原纤维量明显低于阴性药对照组(P<0.01),与正常对照组比较无显著性差异(P>0.05)。含药血清明显抑制LPS激活的体外培养的鼠HSC增殖(P<0.01)。结论:益气活血方药具有明显抗实验性肝纤维化的效应,其作用机制之一是抑制HSC的增殖。     

清肝活血方对酒精性肝纤维化大鼠肝星状细胞增殖与凋亡的影响

目的:观察酒精性肝纤维化大鼠肝星状细胞(HSC)的增殖与凋亡以及清肝活血方的调节作用。方法:雄性Wistar大鼠60只,随机分为空白对照组、模型对照组以及清肝活血方高、中、低剂量组,采用复合因素制备酒精性肝纤维化动物模型。观察清肝活血方对酒精性肝纤维化大鼠肝功能、病理、α-平滑肌动蛋白(α-SMA)以及HSC增殖与凋亡的影响。结果:清肝活血方各剂量组能显著降低酒精性肝纤维化大鼠血清ALT、AST水平(P<0.05);清肝活血方高剂量组能显著降低血清γ-GT水平(P<0.05);各药物组均能在不同程度上减轻肝脏炎症和纤维化,减少肝组织α-SMA的表达(P<0.05),抑制HSC增殖并提高HSC的凋亡率。结论:清肝活血方能有效改善酒精性肝纤维化大鼠肝功能,减轻纤维化程度。其作用机制可能是通过抑制HSC的增殖并促进活化HSC凋亡实现的。     

氧化苦参碱对大鼠肝星状细胞增殖的影响

目的探讨氧化苦参碱对大鼠肝星状细胞增殖的影响及其抗肝纤维化的机理.方法用链酶蛋白酶和胶原酶原位灌流消化正常大鼠肝脏,Nycodenz密度梯度离心分离肝星状细胞,以MTT比色法观察氧化苦参碱对肝星状细胞毒性作用,3H-TdR法观察氧化苦参碱对肝星状细胞增殖的效应.结果氧化苦参碱浓度＞10-5mol/1时对肝星状细胞增殖有抑制作用(P＜0.05).结论氧化苦参碱可抑制肝星状细胞的增殖,有抗肝纤维化的作用.     

大黄素抗肝纤维化的细胞学机制

研究大黄素抗肝纤维化的细胞学机制。分离、培养大鼠肝星状细胞(HSC)并分别以不同剂量的大黄素(大、中、小剂量组分别为(20、10、5)mg/L)干预,测定各组HSC细胞增殖和胶原合成,并测定HSC培养上清液中透明质酸(HA)和层粘连蛋白(LN)含量,结果大黄素干预的HSC增殖、胶原合成、HA及LN合成明显低于正常对照组,且具有剂量依赖关系,结果提示,大黄素对HSC增殖、细胞外基质合成的直接抑制作用可能是其抗肝纤维化的主要作用机制。     

莪术油注射液对肝星状细胞增殖、凋亡及分泌细胞外基质的影响

肝星状细胞(HSC)是肝纤维化发展动态变化网络的核心,抑制活化HSC增殖和诱导其凋亡是治疗肝纤维化的重要策略[1].目前尚缺乏确切有效的抗肝纤维化药物.近年研究发现,中药对肝纤维化的防治具有良好的发展前景[2].莪术(curcumae)是一种传统的活血化瘀中药,药理作用较广,具有抗肿瘤、抗纤维组织增生等作用,对肝纤维化的作用报道较少.本实验研究了莪术油注射液对体外培养HSC增殖、凋亡及分泌细胞外基质的影响,探讨莪术抗肝纤维化作用及其机制.     

抗纤软肝颗粒对大鼠肝星状细胞增殖的影响

目的:探讨抗纤软肝颗粒(KXRG)对大鼠肝星状细胞(HSC)增殖的影响。方法:传代培养的HSC-T6(肝星状细胞系)与KXRG(1.25mg/ml、2.5mg/ml、5mg/ml)及其药物血清(5%、10%、20%)共同培养72小时后,应用MTT法测定细胞增殖、流式细胞仪测定HSC细胞周期各时相的DNA含量。结果:KXRG及药物血清均能显著抑制HSC的增殖,使细胞周期阻滞于S期,且2.5mg/ml药物和10%药物血清作用最强(P0.01)。结论:KXRG通过抑制HSC的活化,阻滞其细胞周期的正常进行,进而抑制HSC增殖,从而起到抗肝纤维化的作用。     

丹酚酸B对大鼠肝星状细胞增殖周期的抑制作用

丹酚酸B(SAB)是丹参的主要水溶性成分，具有良好的抗D-半乳糖胺急性肝损伤和抗四氯化碳诱导的肝纤维化作用，还可抑制肝星状细胞(HSC)增殖及胶原合成，对脂质过氧化有很强的抑制作用，临床上已初步显示具有一定的抗肝纤维化作用。肝纤维化发生过程中，细胞外基质的主要来源是活化的HSC。我们试图在细胞增殖的整体水平上探讨SAB抗肝纤维化的作用机制。     

抗纤方对肝星状细胞活化增殖、凋亡和基质金属蛋白酶-1及其抑制剂表达的影响

目的:观察抗纤方抗肝纤维化的药效学作用。方法:分离培养大鼠HSC,制备抗纤方大鼠药物血清,温育HSC。MTT比色法测定细胞增殖,流式细胞仪检测细胞凋亡。原位杂交法观察MMP-1、TIMP-1的表达。结果:抗纤方可抑制体外培养的HSC增殖,经抗纤方作用后,HSC的凋亡明显增多,并促进MMP-1表达。抑制TIMP-1的表达。结论:抗纤方抗肝纤维化可能机理为抑制HSC增殖,促进其凋亡,促进HSC表达MMP-1,抑制TIMP-1的表达。     

苦参碱对大鼠肝星状细胞增殖和凋亡的影响

目的研究苦参碱对体外培养肝星状细胞(HSC)增殖与凋亡的影响,探讨苦参碱抗肝纤维化作用机制。方法用0.125、0.25、0.5mgml的苦参碱分别处理HSC细胞系rHSC99和肝细胞株HL770224h后,MTT比色法检测细胞增殖,AnnexinVFITCPI双染色流式细胞分析法检测早期细胞凋亡,TUNEL法原位检测DNA断裂,透射电镜观察形态改变。结果①苦参碱对HSC增殖有明显的抑制作用,且作用呈剂量依赖性;苦参碱对肝细胞增殖有促进作用,但促增殖作用不随浓度增加而增强。②AnnexinVFITCPI双染色流式细胞分析:对照组、苦参碱0.125mgml组、0.25mgml组、0.5mgml组凋亡率分别为0.99%±0.45%、5.00%±0.98%、13.6%±2.19%、17.2%±2.17%,差异有显著性(F=63.14,P<0.05)。苦参碱处理组细胞TUNEL检测发现DNA断裂,透射电镜下见核仁消失,染色质浓缩并凝聚成团块状,沿核膜排列。结论苦参碱可抑制HSC增殖、诱导HSC凋亡,可能是其抗肝纤维化机制之一。     

蕲艾提取液药物血清对大鼠肝星状细胞凋亡的影响

目的：研究蕲艾提取液药物血清对大鼠肝星状细胞（HSC）凋亡的影响。方法：传代培养的HSC—T6与蕲艾提取液药物血清共同培养24小时后,采用Annexin V／PI对双染结合流式细胞仪检测细胞凋亡。结果：蕲艾提取液药物血清组早期细胞凋亡率显著高于空白对照组及生理盐水血清组（P〈0．01）,并且随着血清浓度的增加,HSC—T6早期细胞凋亡率逐渐增高,呈剂量依赖关系。结论：蕲艾提取液药物血清促进HSC凋亡,这可能是蕲艾提取液药物血清抗肝纤维化作用机制之一。     

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。