reg I基因表达与肠黏膜损害在急性坏死性胰腺炎中的相关性

目的:研究reg I,在急性坏死性胰腺炎(acute necrotizing pancreatitis,ANP)大鼠肠组织中的表达,探讨该基因的表达与ANP肠黏膜损害的关系.方法:Sprague-Dawley大鼠随机分为假手术对照组(n=40)和ANP组(n=80).对照组开腹后只翻动胰腺,ANP组大鼠胰胆管恒速逆行注射30 g/L牛磺胆酸钠,制成ANP大鼠模型.观察胰腺和小肠的病理改变及小肠黏膜通透性的改变,应用逆转录聚合酶链反应(RT-PCR)检测胰腺、小肠组织中reg Ⅰ mRNA的表达水平,并研究所观察指标与reg Ⅰ,基因表达的相关性.结果:ANP组大鼠术后12,24和36 h肠黏膜组织病理学评分明显高于对照组(1.8±0.89 vs0.2±0.42.3.3±1.17 vs 0.3±0.48,4.2±0.95vs 0.3±0.48,均P<0.01);ANP组大鼠[99mTc]-DTPA排泄率术后12,24和36 h较对照组均明显增加(34.70%±4.03%vs 4.62%±1.17%,54.63%±6.94%vs 6.14%±1.42%.66.83%±7.56%vs 7.48%±0.92%,均P<0.01):与对照组相比,ANP组大鼠小肠组织reg Ⅰ的mRNA水平过度表达,rcg Ⅰ的表达水平分别与肠黏膜病理学评分和肠黏膜通透性指数正相关(r=0.6728,0.7092,均P<0.01).结论:ANP时大鼠小肠组织中regⅠmRNA的表达水平明显上调且与ANP所致肠黏膜损害的严重程度相关.     

谷氨酰胺对急性胰腺炎大鼠肠黏膜胰岛素样生长因子表达及肠黏膜屏障的影响

目的 观察急性坏死性胰腺炎（ANP）时肠黏膜屏障的损伤情况,以及谷氨酰胺（Gln）和胰岛素样生长因子（IGF）对肠黏膜屏障的保护作用.方法 成功诱导ANP模型雄性Wistar大鼠48只,随机分为ANP组和Gln组各24只,另取假手术组24只作为对照.Gln组每日以Gln灌胃2次,剂量为1.5g/（kg·d）;ANP组和假手术组以同等量的生理盐水灌胃.分别在模型制作术后3、6、24、48 h时间点杀死大鼠,取胰头和末端回肠3～5 cm放入液氮中保存.观察胰腺和肠黏膜组织形态学改变,测定肠黏膜中IGF-1的表达、血清中二氨氧化酶（DAO）活性和内毒素浓度.结果 ANP组大鼠肠黏膜屏障功能严重破坏,肠道通透性明显增加,肠黏膜损伤评分明显增加;血清内毒素浓度、DAO活性明显升高（P均＜0.01）.与ANP组比较,Gln组动物肠黏膜损伤减轻,损伤评分有所下降,血清内毒素水平、DAO活性下降（P均＜0.05）.ANP组IGF-1表达水平明显下降（P ＜0.05）;Gln组明显升高（P＜0.05）,同时肠黏膜屏障功能得到一定的改善.结论 ANP时肠黏膜屏障结构和功能存在严重破坏;Gln能一定程度上减轻肠黏膜屏障损伤并能维护其功能;IGF-1参与Gln对ANP肠黏膜屏障损伤的修复和维持.     

急性出血坏死性胰腺炎大鼠肠道黏膜屏障功能变化及己酮可可碱对其的保护作用

目的 研究急性坏死性胰腺炎(ANP)大鼠肠道屏障功能改变及己酮可可碱(pentoxifylline,FTX)对肠道屏障的保护作用.方法 54只SD雄性大鼠按数字表法随机分为ANP组、PTX组和假手术组.采用逆行胰胆管注射5%牛磺胆酸钠建立ANP模型.假手术组只翻动十二指肠.PTX组在制模后经阴茎静脉注射PTX 25 mg/kg体重.术后3、6、24 h分批处死大鼠.取血测淀粉酶、D乳酸及TNF-α含量,取胰腺及末端回肠常规行病理学检查,免疫组化法检测回肠黏膜上皮紧密连接蛋白ZO-1的表达.结果 建模后6 h,ANP组血清淀粉酶、TNF-α、D-乳酸含量分别为(9141±672)U/L、(347.96±79.47)pg/ml和(10.21±1.08)mg/L,显著高于假手术组的(1723±57)U/L、(134.09±31.36)pg/ml和(4.33±0.49)mg/L(P值均＜0.01);PTX组血淀粉酶、TNF-α、D-乳酸分别为(7965±318)U/L、(238.48±44.35)pg/ml和(8.75±1.28)mg/L,较ANP组显著降低,但仍显著高于假手术组(P＜0.05或＜0.01).假手术组大鼠肠黏膜上皮ZO-1阳性率为(3.29±0.36)%;ANP组为(1.91±0.32)%,较假手术组明显减少(P＜0.05);PTX组为(2.53±0.43)%,较假手术组减少,但较ANP组明显增加(P＜0.05).结论 PTX可减轻ANP大鼠肠黏膜屏障功能的损伤,其机制可能是通过减少肠黏膜上皮ZO-1的降解.     

Cajal间质细胞和肠神经元在急性坏死性胰腺炎豚鼠小肠组织中的改变

目的 探讨Cajal间质细胞(ICC)和肠胶质神经元数量在ANP豚鼠小肠组织中的改变及对肠动力的影响.方法 24只豚鼠随机分为对照组、ANP 24 h组和48 h组,各8只.采用腹腔注射20%L-精氨酸制作ANP模型.器官浸浴技术评价离体小肠的运动.HE染色观察胰腺和小肠组织病理改变.应用免疫荧光法检测ICC标志物酪氨酸激酶(C-KIT)和肠神经胶质细胞标志物的蛋白基因产物9.5 (PGP9.5).结果 ANP 24 h和48 h组胰腺组织呈明显水肿、坏死,小肠黏膜腺体结构紊乱,炎症细胞浸润.小肠运动的频率分别为(10.25±1.56)次/min和(10.37±1.41)次/min,运动振幅分别为(159.65±24.30)g*s和(156.64±17.01)g*s,较对照组明显下降;肌间丛ICC量从对照组的(0.273±0.03)%降至ANP组(0.104±0.04)%和(0.129±0.05)%,而肠神经元数量无明显变化.结论 ANP豚鼠模型存在小肠动力功能的障碍,肠肌间丛Cajal间质细胞数量的减少可能是小肠动力功能抑制的重要因素.     

紧密连接蛋白occludin在急性坏死性胰腺炎大鼠脑微血管内皮细胞的表达

目的 研究ANP大鼠脑微血管内皮细胞紧密连接蛋白occludin表达的变化及与胰腺病变程度的关系.方法 80只大鼠按完全随机法分为假手术(SO)组和ANP 3、6、12、24 h组.以5%胆酸钠逆行性胰胆管注射诱导ANP大鼠动物模型,行胰腺组织病理学评价,应用免疫组织化学法、RT-PCR法及Western blotting法检测大鼠脑微血管内皮细胞间紧密连接蛋白occludin及其mRNA表达.结果 occludin蛋白沿脑血管线性表达.ANP 3 h组蛋白表达量从S0组的0.49±0.08下降到0.35±0.09;occludin mRNA表达从1.50±0.30减少到1.01±0.18(P<0.05).ANP 6 h组达最低值,分别为0.26±0.07和0.93±0.19.ANP 12、24 h组occludin蛋白和mRNA表达量又较ANP 6 h组增加(P<0.05),但仍低于SO组(P<0.05).occludin蛋白及mRNA表达与胰腺组织损害程度呈明显负相关(Pearson相关系数分别为-0.48和-0.536,P<0.05).结论 在ANP进程中,脑微血管内皮细胞间紧密连接蛋白occludin及其mRNA均呈下调趋势,且与胰腺病变程度呈负相关.     

大黄附子汤对急性坏死性胰腺炎大鼠小肠黏膜屏障功能的保护作用

目的 探讨大黄附子汤对急性坏死性胰腺炎(ANP)大鼠小肠黏膜屏障功能的影响及意义.方法 将60只SD大鼠按数字表法随机分为假手术组(19只)、ANP组(21只)和大黄附子汤治疗组(20只).经胰胆管逆行注入4%牛磺且酸钠1 ml/kg体重建立ANP模型,同时行空肠造瘘.治疗组于制模后0.5 h经空肠造瘘管注入大黄附子汤2 ml,隔4、8 h再注入2 ml;其他两组注入等容积生理盐水.术后24 h经腹主动脉取血,测定血淀粉酶、内毒素、D-乳酸含量及二胺氧化酶(DAO)活性.取胰腺、小肠组织行病理学检查,测定肠上皮损伤指数,观察小肠黏膜超微结构改变.结果 假手术组大鼠血淀粉酶、内毒素、D-乳酸含量及DAO活性分别为(152±32)U/L、(6.95±2.10)pg/L、(3.96±1.08)μg/ml和(14.26±2.67)μg/ml,ANP组分别为(1549±93)U/L、(40.48±3.41)pg/L、(12.34±1.23)μg/ml和(80.28±3.54)μg/ml,治疗组分别为(655±49)U/L、(19.55±2.50)pg/L、(6.75±1.36)μg/ml和(20.69±7.53)μg/ml,ANP组较假手术组明显升高,而治疗组较ANP组显著降低,但仍高于假手术组(P＜0.05或＜0.01).ANP组小肠黏膜厚度、绒毛高度分别为(389.44±29.87)μm、(16.52±3.73)μm,显著低于治疗组的(501.95±45.38)μm、(27.82±5.17)μm,更显著低于假手术组的(658.72±57.49)μm和(35.49±6.43)μm;而肠上皮损伤指数为3.72±0.65,显著高于治疗组的2.12±0.37和假手术组的0.85±0.24.同时,大黄附子汤治疗后小肠黏膜组织学和超微结构改变亦均较ANP组明显减轻.结论 大黄附子汤可明显减轻ANP大鼠小肠黏膜屏障功能损害的程度.     

胰岛素样生长因子-Ⅰ对重症急性胰腺炎大鼠小肠黏膜上皮细胞bax和bcl-2 mRNA表达的影响

目的:研究外源性胰岛素样生长因子-Ⅰ(insulin-like growth factor-Ⅰ,IGF-Ⅰ)对重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠小肠黏膜上皮细胞凋亡及凋亡相关基因bax、bcl-2 mRNA表达的影响,探讨其对肠道屏障保护作用的机制.方法:72只♂Wistar大鼠按照随机数字表法分为假手术组(SO组,n=24)、重症急性胰腺炎组(SAP组,n=24)、IGF-Ⅰ治疗组(IGF-Ⅰ组,n=24).各组动物分别于术后6、12、24 h各处死8只,检测血浆淀粉酶,观察小肠组织病理学变化,TUNEL法检测小肠黏膜上皮细胞凋亡,RT-PCR检测小肠上皮细胞中bax和bcl-2mRNA的表达.结果:与SAP组各时相点相比,IGF-Ⅰ治疗组大鼠小肠黏膜上皮细胞凋亡指数显著降低(6h:13.88±1.73 vs 19.00±2.78;12 h:10.13±1.55 vs 17.63±1.60;24 h:9.50±1.07 vs 17.25±2.76;均P<0.05),小肠组织病理变化明显改善:小肠组织中bax mRNA的表达在IGF-Ⅰ组的各时相点较SAP组明显减弱(6 h:1.10±0.02vs 1.19±0.04;12 h:0.97±0.04 vs 1.16±0.02;24 h:0.87±0.03 vs 1.14±0.03,均P<0.05);bcl-2 mRNA的表达在IGF-Ⅰ组各时相点与SAP组相比明显增强(6 h:0.65±0.02 vs 0.57±0.02;12 h:0.69±0.04 vs 0.57±0.01;24 h:0.72±0.02 vs 0.58±0.01,均P<0.05).结论:外源性IGF-Ⅰ可以减轻SAP时肠黏膜的损伤.     

血管活性肠肽对急性坏死性胰腺炎大鼠肠黏膜屏障功能的影响

目的 探讨血管活性肠肽(VIP)对ANP大鼠肠黏膜损伤的影响.方法 54只SD大鼠随机分成假手术组(SO)、ANP组和VIP组,每组分制模后1 h、6 h、12 h 3个时间点,各6只.采用4%牛磺胆酸钠胰胆管逆行注射制备ANP模型,VIP组在制模后5 min腹腔内注射VIP 5 nmol.ELISA法检测血浆及肠组织匀浆VIP水平;MB-80微生物快速动态检测系统检测血浆内毒素水平;RT-PCR法检测肠黏膜组织TNF-α、IL-6、IL-10 mRNA表达;肠黏膜行病理学检查.结果 ANP组肠黏膜结构损害明显,VIP组病变减轻.ANP组血浆及肠黏膜VIP水平在制模后6 h分别为(49.582 ±3.735)pg/ml和(87.731 ±4.601)pg/g pro,均显著低于SO组(P＜0.05),制模后12 h分别为(65.192±5.785)pg/ml和(110.978 ±6.420)pg/g pro,高于SO组;ANP组制模后6 h血浆内毒素水平、肠黏膜TNF-α、IL-6、IL-10mRNA表达量分别为(29.570±5.127)pg/ml、0.861±0.081、1.150±0.187和0.786±0.102,均显著高于SO组(P＜0.05).VIP组制模后6 h血浆内毒素水平、肠黏膜TNF-α、IL-6 mRNA表达分别为(20.486 ±2.811)pg/ml、0.707 ±0.095和0.889 ±0.136,均较ANP组下降(P＜0.05);IL-10 mRNA表达为0.992 ±0.126,较ANP组增高(P＜0.05).结论 VIP对ANP大鼠肠黏膜损伤具有明显的保护作用.     

重组肠三叶因子对急性坏死性胰腺炎大鼠肠黏膜保护作用的研究

目的 探讨重组肠三叶因子(rITF)对急性坏死性胰腺炎(ANP)大鼠肠黏膜的保护作用及其机制.方法 SD雄性大鼠60只,按随机数字表法分为对照组、ANP组、rITF组,每组20只.逆行胰胆管注射5%牛黄胆酸钠100μl/100 g体重制备ANP模型.rITF组制模前后尾静脉注射rITF 0.5mg/100 g体重,对照组及ANP组注射等量生理盐水,术后12、24 h分批处死大鼠.取血检测淀粉酶含量,取末端回肠组织观察病理学改变并予评分、免疫组化法检测肠黏膜NF-κB活性,RT-PCR法检测肠黏膜TNF-α mRNA、ICAM-1 mRNA的表达.结果 ANP组和rITF组血淀粉酶水平较同时点对照组均显著升高.ANP组肠黏膜损伤评分较同时点对照组高(P＜0.05);ANP 12 h组较rITF 12 h组高(P＜0.05),但24 h组间评分无明显差异.对照组、ANP组与rITF组12 h肠黏膜NF-κB阳性细胞数分别为(26±4)个、(55±8)个、(49±4)个;回肠组织TNF-α mRNA相对表达量分别为0.050±0.005、1.040±0.031和0.792±0.0256;回肠组织ICAM-1 mRNA相对表达量分别为0.045±0.010、0.795±0.037和0.400±0.031.ANP组上述各项指标值均较对照组显著增加(P＜0.05或P＜0.01),而rITF下组又较ANP组均显著减少(P＜0.05).结论 重组肠三叶因子对ANP大鼠肠黏膜具有保护作用,其机制可能通过抑制肠黏膜NF-κB活化,下调TNF-αmRNA、ICAM-1 mRNA表达.     

reg I基因表达与肠黏膜损害在急性坏死性胰腺炎中的相关性

目的: 研究regⅠ在急性坏死性胰腺炎(acute necrotizing pancreatitis, ANP)大鼠肠组织中的表达, 探讨该基因的表达与ANP肠黏膜损害的关系. 方法: Sprague-Dawley大鼠随机分为假手术对照组(n = 40)和ANP组(n = 80). 对照组开腹后只翻动胰腺, ANP组大鼠胰胆管恒速逆行注射30 g/L牛磺胆酸钠, 制成ANP大鼠模型. 观察胰腺和小肠的病理改变及小肠黏膜通透性的改变, 应用逆转录聚合酶链反应(RT-PCR)检测胰腺、小肠组织中regⅠ mRNA的表达水平, 并研究所观察指标与regⅠ 基因表达的相关性. 结果: ANP组大鼠术后12, 24和36 h肠黏膜组织病理学评分明显高于对照组(1.8±0.89 vs 0.2±0.42, 3.3±1.17 vs 0.3±0.48, 4.2±0.95 vs 0.3±0.48, 均P<0.01); ANP组大鼠[99mTc]-DTPA排泄率术后12, 24和36 h较对照组均明显增加(34.70%±4.03% vs 4.62%±1.17%, 54.63%±6.94% vs 6.14%±1.42%, 66.83%±7.56% vs 7.48%±0.92%, 均P<0.01); 与对照组相比, ANP组大鼠小肠组织中reg Ⅰ的mRNA水平过度表达, reg Ⅰ的表达水平分别与肠黏膜病理学评分和肠黏膜通透性指数正相关(r = 0.6728, 0.7092, 均P<0.01). 结论: ANP时大鼠小肠组织中regⅠ mRNA的表达水平明显上调且与ANP所致肠黏膜损害的严重程度相关.     

Role of pentoxifylline in non-alcoholic fatty liver disease in high-fat diet-induced obesity in mice

AIM:To study pentoxifylline effects in liver and adipose tissue inflammation in obese mice induced by high-fat diet(HFD).METHODS: Male swiss mice(6-wk old) were fed a highfat diet(HFD; 60% kcal from fat) or AIN-93(control diet; 15% kcal from fat) for 12 wk and received pentoxifylline intraperitoneally(100 mg/kg per day) for the last 14 d. Glucose homeostasis was evaluated by measurements of basal glucose blood levels and insulin tolerance test two days before the end of the protocol. Final body weight was assessed. Epididymal adipose tissue was collected and weighted for adiposity evaluation. Liver and adipose tissue biopsies were homogenized in solubilization buffer and cytokines were measured in supernatant by enzyme immunoassay or multiplex kit, respectively. Hepatic histopathologic analyses were performed in sections of paraformaldehyde-fixed, paraffin-embedded liver specimens stained with hematoxylin-eosin by an independent pathologist. Steatosis(macrovesicular and microvesicular), ballooning degeneration and inflammation were histopathologically determined. Triglycerides measurements were performed after lipid extraction in liver tissue. RESULTS: Pentoxifylline treatment reduced microsteatosis and tumor necrosis factor(TNF)-α in liver(156.3 ± 17.2 and 62.6 ± 7.6 pg/mL of TNF-α for non-treated and treated obese mice, respectively; P 0.05). Serum aspartate aminotransferase levels were also reduced(23.2 ± 6.9 and 12.1 ± 1.6 U/L for nontreated and treated obese mice, respectively; P 0.05) but had no effect on glucose homeostasis. In obese adipose tissue, pentoxifylline reduced TNF-α(106.1 ± 17.6 and 51.1 ± 9.6 pg/mL for non-treated and treated obese mice, respectively; P 0.05) and interleukin-6(340.8 ± 51.3 and 166.6 ± 22.5 pg/mL for non-treated and treated obese mice, respectively; P 0.05) levels; however, leptin(8.1 ± 0.7 and 23.1 ± 2.9 ng/mL for non-treated and treated lean mice, respectively; P 0.05) and plasminogen activator inhibitor-1(600.2 ± 32.3 and 1508.6 ± 210.4 pg/mL for non-treated and treated lean mice, respectively; P 0.05) levels increased in lean adipose tissue. TNF-α level in the liver of lean mice also increased(29.6 ± 6.6 and 75.4 ± 12.6 pg/mL for non-treated and treated lean mice, respectively; P 0.05) while triglycerides presented a tendency to reduction.CONCLUSION: Pentoxifylline was beneficial in obese mice improving liver and adipose tissue inflammation. Unexpectedly, pentoxifylline increased pro-inflammatory markers in the liver and adipose tissue of lean mice.     

岳阳市城区小学生血吸虫病防治健康教育现状调查

目的 调查湖南省岳阳市城区小学生血吸虫病防治知识、行为现状及健康教育需求情况,为制定科学有效的小学生血吸虫病健康教育方案提供参考依据。方法 采用分层整群抽样方法,抽取岳阳市城区洞庭湖湖畔学校和中心城区学校各2所,每所再从五、六年级分别抽取2个班的学生,通过调查问卷了解小学生血吸虫病相关知识、预防行为及健康教育需求,并进行统计分析。结果 共调查湖畔小学353人、中心城区小学363人,两组学校小学生年龄、性别、年级构成差异无统计学意义（t=-0.494,χ²_性别=1.615,χ²_年级=2.152;P均>0.05）。学生血吸虫病防治知识总知晓率为42.60%（305/716）,其中,湖畔学校小学生血防知识知晓率（52.97%）高于中心城区（32.51%）,差异有统计学意义（χ²=30.661,P<0.05）;学生行为正确率为76.68%（549/716）,血防知识知晓组行为正确率（81.31%）高于不知晓组（71.24%）,差异有统计学意义（χ²=6.384,P<0.05）。学生血防知识主要来源于老师（47.49%）;91.90%的学生愿意了解更多的血防知识,最喜欢的血防知识学习方式是参加课外活动（50.42%）。结论 岳阳市城区小学生的血防知识知晓率及行为正确率偏低,对血吸虫病防治健康教育需求较高。建议针对学生开展形式多样的血防健康教育,以增强学生的血吸虫病防护意识,提高自我防护能力。     

RNA-Seq在老年神经退行性疾病研究中的应用

阿尔茨海默病及帕金森病是老年人最常见的两种神经退行性疾病,但其发病机制及治疗是研究的热点。随着高通量测序技术的进步及成本的下降,RNA-Seq也成为神经退行性疾病机制研究及生物标志物发现的有力手段。RNA-Seq相对于microarray具有高灵敏度、高准确性、高重复性以及噪声低等优势,在阿尔茨海默病及帕金森病研究中有较为广泛的应用,包括检测差异表达基因,可变剪接、新长链非编码RNA预测分析和miRNAs调控等,但是容易受病理复杂性及样本等因素影响。目前阿尔茨海默病及帕金森病转录组研究相比于癌症等还不够深入,在临床诊断及治疗应用还面临较大挑战。但是随着新技术及新方法的发展,RNA-Seq将进一步推动神经退行性相关疾病的研究和临床转化。     

Role of microRNA in regulation of myeloma-related angiogenesis and survival

Multiple myeloma (MM) is a malignant disease caused by clonal proliferation of plasma cells that result in monoclonal gammopathy and severe end organ damage. Despite the uniform clinical signs, the disease is very diverse in terms of the nature and sequence of the underlying molecular events. Multiple cellular processes are involved in helping the malignant cells to remain viable and maintain proliferative properties in the hypoxic microenvironment of the bone marrow. Specifically, the process of angiogenesis, triggered by the interactions between the malignant MM cells and the stroma cells around them, was found to be critical for MM progression. In this review we highlight the current understanding about the epigenetic regulation of the proliferation and apoptosis of MM cells and its dependency on angiogenesis in the bone marrow that is carried out by different microRNAs.     

Use of fab fragments of digoxin-specific antibodies in the therapy of massive digoxin poisoning

A case of massive digoxin ingestion with multiple arrhythmias, consisting of high grade A-V block and ventricular ectopy not responsive to lidocaine, is described. The arrhythmias ceased following administration of digoxin-specific Fab fragments. The patient improved and was transferred to the psychiatric unit.     

Rising incidence of oesophageal adenocarcinoma in men in Australia

Adenocarcinomas of the oesophagus and of the gastric cardia have been reported to be increasing in incidence in many countries, while the incidence of squamous cell carcinoma of the oesophagus is stable and non-cardia gastric cancers are decreasing in incidence. Age-standardized incidence rates for the years 1982–93 for oesophageal adenocarcinoma and non-adenocarcinoma, and gastric cardia and non-cardia cancers were calculated based on state cancer registry incidence data. Time trends in the age-standardized rates were assessed using linear regression. A consistent increasing trend in the incidence of oesophageal adenocarcinoma in men was seen in all states of Australia and was statistically significant in all states except South Australia. There were no consistent nationwide trends in the incidence of oesophageal adenocarcinoma in women, although a trend towards an increase in the incidence of this cancer reached statistical significance ( P < 0.05) in three states (New South Wales, Victoria, Queensland). There were no important trends in the incidence of oesophageal non-adenocarcinoma in either men or women. There were no consistent nationwide changes in the incidence of gastric cardia cancer in either men or women, although this cancer was significantly increasing in Tasmania in both men and women. The incidence of cancer of the stomach not arising at the gastric cardia was significantly decreasing in men in all states and was also decreasing in women in all states, although in women this decrease was statistically significant only in New South Wales, Victoria and Western Australia. There has been a dramatic increase in the incidence of oesophageal adenocarcinoma in men in Australia. The incidence of this cancer in men is now approximately equal with that of non-adenocarcinoma of the oesophagus. The incidence of non-cardia stomach cancer continues to fall.     

Comparison of intravenous and oral routes of theophylline loading in acute asthma

In a prospective, randomized clinical trial, 19 patients with an acute exacerbation of asthma were given a loading dose of aminophylline by the IV (n = 10) or oral route (n = 9) of administration following treatment with epinephrine. Plasma concentrations of theophylline were measured prior to giving the loading dose, and one, two, three, and 24 to 48 hours later. Therapeutic effectiveness was evaluated by analyzing spirometric measurements prior to giving the loading dose, and one, three, and 24 to 48 hours later. Side effects also were recorded. In the IV group, the mean peak plasma theophylline concentration was 15.1 micrograms/mL one hour after loading, and in the oral group the mean peak serum theophylline concentration was 14.2 micrograms/mL three hours after loading. There was no correlation between theophylline concentrations and normalized change in spirometric values. There was no significant difference in spirometric values between the IV and oral groups. Nausea was slightly more common in the IV group. We conclude that there is no therapeutic advantage to giving a loading dose of aminophylline by the IV route rather than orally in patients with mild-to-moderate exacerbation of asthma initially treated with epinephrine.     

Propranolol-induced hypertension in treatment of cocaine intoxication

The case of a patient with apparent cocaine toxicity and drug-mediated hypertension and tachycardia is presented. IV propranolol was used as the initial treatment for his hyperadrenergic state, resulting in a decrease in heart rate but a paroxsymal increase in blood pressure. The patient required nitroprusside for control of elevated blood pressure. A mechanism of unopposed alpha stimulation as a result of beta-2 receptor blockade is proposed, and a cautious approach to the use of propranolol in these patients is suggested.     

Histamine antagonists in the treatment of shock hyperglycemia in the rat

The present study was undertaken to determine the effect of exogenous histamine and histamine blockers on blood glucose and hepatic glycogen in the rat. Forty-one nonfasted male Sprague-Dawley rats that had been anesthetized with intraperitoneal injections of urethane were injected intravenously (femoral) with histamine (10 mg/kg) five minutes after pretreatment with Ringer's solution (control), diphenhydramine (1 mg/kg) (H-1 blocker); metiamide (1 mg/kg) (H-2 blocker); or a combination of these blockers. Mean arterial pressure (carotid), blood glucose, and hepatic glycogen were measured. Within 30 minutes, histamine evoked a significant increase in blood glucose, and a decrease in hepatic glycogen, and a reduction in blood pressure. However, rats treated with the H-2 blocker metiamide or with a combination of H-1 and H-2 blockers did not show as significant a hypotensive response as rats treated with the H-1 blocker diphenhydramine alone. The hyperglycemic-glycogenolytic response to histamine was modified by diphenhydramine as well as by a combination of blockers, but not by metiamide alone. These results suggest that a) the hypotension did not initiate the hyperglycemic and glycogenolytic response; b) the H-2 blocker metiamide has little effect on the hyperglycemic response to exogenous histamine; and c) the H-1 blocker diphenhydramine may have antihyperglycemic properties.