KLK4 mRNA实时荧光定量检测方法研究

应用SYBR Green I作荧光染料，利用磷酸甘油醛脱氢酶（GAPDH）作内对照，建立KLK4mRNA的实时荧光定量（FQ—PCR）检测方法。结果建立的FQ—PCR方法扩增GAPDH和KLK4mRNA的效率分别为0．98和0．96；检测GAPDH和KLK4的批内变异系数（CV）分别为0．8％和1．6％，批间CV分别为3．9oA和2．4％；基因扩增产物DNA序列分析及熔解曲线分析表明该方法特异可靠。认为本研究建立的FQ—PCR检测方法简便、特异、重复性好、可信度高，可为KLK4基因表达水平的研究提供基础。     

熊去氧胆酸对肝内胆汁淤积大鼠多药耐药相关蛋白2的影响及意义

目的：制备大鼠肝内胆汁淤积模型,检测熊去氧胆酸干预前后多药耐药相关蛋白2（MRP2）表达的变化。方法：采用Wistar雄性大鼠灌服α-荼基异硫氰酸酯（ANIT）制备肝内胆汁淤积模型,分别以生理盐水、地塞米松、熊去氧胆酸干预大鼠5天后,检测肝功能,并取肝脏,采用实时荧光定量RT—PCR方法检测肝组织MRP2基因mRNA水平．Western—blot检测肝组织内MRP2蛋白水平。结果：与生理盐水组大鼠相比,地塞米松组和熊去氧胆酸组肝功能检测总胆红素、直接胆红素显著降低（P〈0．01）,肝组织MRP2基因mRNA水平、蛋白水平显著升高（P〈0．01）。结论：地塞米松和熊去氧胆酸均能降低胆红素水平,其作用机制可能与两种药物上调MRP2基因表达有关。     

四氯化碳诱导肝组织胶原和TIMP-1mRNA的表达及干预研究

40％四氯化碳制备大鼠肝纤维化模型，并应用不同剂量中药小柴胡汤进行干预；通过免疫组化方法检测肝组织中胶原Ⅰ型及纤维连接蛋白，运用定量逆转录聚合酶链反应法（RT—PCR）检测肝脏内金属蛋白酶1组织抑制因子（TIMP-1）mRNA的表达。结果肝纤维化发生时，肝脏胶原含量显著增加，TIMP-1mRNA显著增高（P〈0．01）；小柴胡汤治疗组肝脏胶原含量及TIMP-1mRNA显著降低（P〈0．01）；同期不同剂量小柴胡汤治疗组之间肝脏胶原含量及TIMP-1mRNA无明显差异。认为肝纤维化发生时，胶原Ⅰ型及纤维连接蛋白含量显著增高，TIMP-1mRNA的表达亦显著增高。小柴胡汤能减轻大鼠肝纤维化的程度，在肝纤维化早期可下调TIMP-1mRNA的表达。     

褪黑素对自身免疫性肝炎大鼠肝星状细胞透明质酸、Ⅲ型前胶原分泌及Ⅰ型胶原mRNA表达的抑制作用

本研究在自身免疫性肝炎（AIH）大鼠模型肝星状细胞培养过程中加入褪黑素（MT），检测培养上清中透明质酸（HA）和Ⅲ型前胶原（PCⅢ）的含量，并采用RT—PCR法观察MT对肝星状细胞（HSC）表达Ⅰ型胶原（colⅠ）mRNA的影响。     

抵抗素mRNA在非酒精性脂肪性肝炎大鼠肝组织中的表达与定位

目的观察高脂饮食诱导的非酒精性脂肪性肝炎（NASH）大鼠肝组织抵抗素mRNA的表达与定位，探讨其在NASH发病中的作用。方法16只雄性Wistar大鼠被随机分为普通饲料和高脂饲料喂养组，连续18周后处死各组大鼠，测定血清甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、游离脂肪酸（FFA）、肿瘤坏死因子（TNF-α）、空腹血糖（FBS）和空腹胰岛素（FINS），并计算胰岛素敏感指数（ISI），观察肝脏组织病理变化和炎症活动度计分；应用原位杂交和半定量RT—PCR技术检测各组大鼠肝脏组织抵抗素mRNA的表达及定位。结果模型组肝组织抵抗素mRNA表达较正常组显著性升高，其阳性颗粒主要分布于小叶内及汇管区炎细胞浸润区的巨噬细胞胞浆中。模型组肝组织抵抗素和血清TNF-α水平、肝脏炎症活动度计分成显著性正相关（r=0．873，0．892，P〈0．01），但与ISI无相关。结论NASH模型大鼠肝脏抵抗素定位于小叶内及汇管区炎细胞浸润区的巨噬细胞胞浆中，参与NASH的炎症发病机制。     

沙利度胺对大鼠肝纤维化基质金属蛋白酶-13及其抑制因子-1表达的影响

目的观察沙利度胺逆转大鼠肝纤维化的疗效和对基质金属蛋白酶-13（MMP-13）及金属蛋白酶组织抑制因子-1（TIMP-1）表达的影响。方法大鼠随机分为正常对照组、模型对照组、自动逆转组和沙利度胺组。四氯化碳腹腔注射诱导大鼠肝纤维化模型,造模成功后用沙利度胺100mg／kg灌胃治疗。观察肝组织病理学改变,检测肝功能、血清学肝纤维化指标及肝组织羟脯氨酸含量,免疫组化方法检测MMP-13、TIMP-1、d-平滑肌肌动蛋白（α-SMA）在肝内表达和分布,RT—PCR检测肝组织MMP-13、TIMP-1mRNA表达。结果与自动逆转组相比,沙利度胺可显著降低肝脏炎症活动度和肝纤维化程度,降低ALT、AST并升高前自蛋白（PA）,降低羟脯氨酸含量,增加肝组织MMP-13蛋白和mRNA表达,降低肝组织α—SMA蛋白、TIMP-1蛋白和mRNA表达。结论沙利度胺可有效地逆转实验性大鼠肝纤维化,通过降低α-SMA表达的途径来调节MMP-13和TIMP-1的表达可能是其重要作用机制。     

乌司他丁对内毒素诱导急性肝衰竭模型大鼠过氧化物酶体增殖物激活受体γ基因表达的影响

目的研究乌司他丁（ulinastatin,UTI）对急性肝衰竭（acute liver failure,ALF）大鼠肝组织中过氧化物酶体增殖物激活受体γ（peroxysome proliferator—activated receptorγ,PPAR-γ,）表达的动态影响。方法将SD大鼠随机分成空白组、模型组和乌司他丁治疗组,采用腹腔注射D-氨基半乳糖（D—galactosamine,D—Gal）、脂多糖（lipopolysaccharide,LPS）建立急性肝衰竭大鼠模型。治疗组在造模前30min腹腔注射UTI,各组于造模后6h、12h、24h、48h4个时间点留取大鼠血及肝脏标本。观察大鼠肝功能及肝脏病理变化;RT—PCR法测定各组肝PPAR-γ mRNA表达水平;ELISA法测定血清中肿瘤坏死因子-α（tumor necrosis factor—α,TNF-α）,白细胞介素-6（interleukin-6,IL-6）水平。结果肝衰竭模型组大鼠肝PPAR-γ mRNA表达明显低于空白组,乌司他丁治疗组大鼠肝PPAR—γ水平明显高于模型组,组间比较差异有显著性。结论乌司他丁可能通过提高PPAR—γ mRNA水平对急性肝衰竭起到保护作用。     

芪参益气滴丸对肝纤维化大鼠肝脏胶原表达的影响

目的：应用二甲基亚硝胺（DMN）建立肝纤维化大鼠模型，研究芪参益气滴丸对纤维化肝组织中Ⅰ、Ⅲ型胶原表达的影响。方法：70只大鼠随机分为正常对照组、模型组、芪参益气滴九干预组、模型对照组及芪参益气滴丸治疗组。采用DMN腹腔内注射的方法建立肝纤维化大鼠模型。按6期分类法评价各组大鼠肝纤维化程度。应用RT—PCR法检测各组大鼠肝组织中Ⅰ、Ⅲ型胶原mRNA水平；应用免疫组织化学技术检测各组动物肝组织Ⅰ、Ⅲ型胶原的表达。结果：芪参益气滴丸干预组与治疗组大鼠的肝纤维化程度、肝组织中Ⅰ型与Ⅲ型胶原mRNA水平及肝组织中Ⅰ型与Ⅲ型胶原的阳性表达，均分别较模型组与模型对照组显著减轻与下降。结论：芪参益气滴丸能明显减轻肝组织病理改变和肝纤维化程度．抑制Ⅰ、Ⅲ型胶原的表达是其抗肝纤维化的机制。     

胃癌患者外周血细胞角蛋白和癌胚抗原mRNA联合表达及意义

近年来，分子生物学技术的发展为胃癌诊断及预后判断提供了新的手段，众多研究显示，巢式逆转录．聚合酶链反应（RT—PCR）技术可检出胃癌患者周围静脉血中微量癌细胞，并经随访发现，这些播散癌细胞有明确预后意义。本研究采用RT—PCR技术，检测胃癌患者外周血中细胞角蛋白（CK）20mRNA及癌胚抗原（CEA）mRNA的表达情况，并探讨其临床意义。     

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。