口服阿苯达唑抗小鼠旋毛虫成囊期幼虫的效果观察

目的观察口服不同剂量阿苯达唑抗小鼠旋毛虫成囊期幼虫的效果。方法BALB/c小鼠72只,随机均分为9组,每只小鼠口饲感染旋毛虫成囊期幼虫50条。感染后第29天,分别口服阿苯达唑50、100、150、200、250、300、350和400 mg/(kg.d),每天固定时间给药1次,连续6 d。对照组不作处理。停药后第7天,脱颈处死小鼠,肌肉压片法检查小鼠膈肌、咬肌和腓肠肌中幼虫,观察成囊期幼虫存活情况,计算每克肌肉总虫数、活虫数和死虫数,以及总减虫率和活虫减少率,评价各剂量组疗效。结果当阿苯达唑剂量为50～250 mg/(kg.d)时,膈肌、咬肌和腓肠肌中成囊期幼虫总虫数和活虫数均随剂量升高呈下降趋势,而死虫数呈上升趋势;但当阿苯达唑剂量大于250 mg/(kg.d)时,3个部位肌肉中虫数不再有明显变化。与对照组相比,200 mg/(kg.d)及以上剂量组3个部位肌肉的总虫数和活虫数均显著减少(均P<0.01),其中250 mg/(kg.d)为治疗肌肉期旋毛虫病的适宜剂量,其膈肌、咬肌和腓肠肌的总减虫率分别为50.00%、62.62%和57.48%,活虫减少率分别为79.96%、83.25%和80.56%。结论小鼠连续口服阿苯达唑250 mg/(kg.d)×6 d为其治疗肌肉期旋毛虫病的适宜剂量。     

口服三苯双脒3种不同溶液抗小鼠旋毛虫成囊期幼虫效果观察

目的观察口服三苯双脒3种不同溶剂溶液抗小鼠旋毛虫成囊期幼虫的效果。方法 BALB/c小鼠40只,随机均分为4组,每鼠口饲感染旋毛虫成囊期幼虫50条。感染后第29d,分别用不同溶剂配制的三苯双脒治疗,其中吐温溶剂组三苯双脒用7%吐温-80和3%乙醇溶解,羧纤溶剂组三苯双脒用1%羧甲基纤维素和3%乙醇溶解,羟环溶剂组三苯双脒用7%羟丙基-β-环糊精和3%乙醇溶解,三苯双脒剂量均为200mg/(kg.d),连续给药6d,对照组不治疗。治疗后14d,取小鼠膈肌和腓肠肌,压片法检查成囊期幼虫,观察其存活情况,计数活虫数、死虫数及总虫数,计算克肌肉减虫率、死亡率及相对药效率,以评价药物疗效。结果实验期间所有小鼠未见药物不良反应。与对照组相比,3个治疗组膈肌和腓肠肌中成囊期幼虫总虫数和存活虫数均显著减少(P<0.05或P<0.01),死亡虫数显著增加(P<0.05或P<0.01),以羟环溶剂组的疗效最好。以减虫率计算,羧纤溶剂组对膈肌和腓肠肌中成囊期幼虫相对药效率分别为吐温溶剂组的1.61和2.46倍,羟环溶剂组相应为2.13和2.49倍;以死虫率计算,羧纤溶剂组分别为1.55和1.79倍,羟环溶剂组分别为2.51和2.16倍。结论用1%羧甲基纤维素和3%乙醇或7%羟丙基-β-环糊精和3%乙醇配制三苯双脒的生物药效率和抗旋毛虫成囊期幼虫效果显著提高,以三苯双脒羟环溶液的效果更佳。     

口服三苯双脒不同疗程抗小鼠旋毛虫成囊期幼虫的效果观察

目的比较以不同疗程口服300mg/（kg.d）三苯双脒抗小鼠横纹肌中旋毛虫成囊期幼虫的效果。方法 40只8周龄BALB/c小鼠被随机均分为5组,每只小鼠口饲感染旋毛虫成囊期幼虫50条。感染后第29d,分别以不同疗程（连续给药2、4、6、8 d）口服三苯双脒300mg/（kg.d）治疗,对照组不治疗。记录小鼠健康状况。停药后第7d,颈椎脱臼处死小鼠。肌肉压片法观察小鼠膈肌、咬肌、胸肌、腓肠肌中成囊期幼虫存活情况,计数总虫数、活虫数和死虫数。另取40只8周龄BALB/c小鼠,随机均分为5组,分别用不同疗程治疗后的小鼠膈肌成囊期幼虫50条口饲感染,感染后第29d,肌肉压片法计数膈肌中成囊期幼虫。结果实验期间,各组小鼠健康状况良好,未见药物不良反应。随着疗程的增加,4个部位肌肉中幼虫总虫荷和活虫数均呈下降趋势,而死虫数呈上升趋势。与对照组相比,2 d及2 d以上疗程组膈肌、咬肌和腓肠肌中成囊期幼虫总虫数和存活虫数均显著减少（P〈0.05、P〈0.01）,6 d疗程组和8 d疗程组胸肌总虫数显著减少（P〈0.05、P〈0.01）。随着疗程的增加,膈肌、咬肌、胸肌和腓肠肌的幼虫死亡率呈上升趋势,其中6 d疗程组分别为96.16%、98.06、99.13%和98.56%（P〈0.01）,8 d疗程组为99.62%~100%（P〈0.01）。疗效验证性感染表明,6 d（37.5%）和8 d（12.5%）的感染率显著低于对照组（100%）和2 d（100%）疗程组（P〈0.01）。2 d及以上疗程组小鼠平均虫荷和平均减虫率均显著低于对照组（P〈0.01）。结论口服TBD 300mg/（kg.d）,连续给药6 d或8 d,无不良药物反应,可有效杀死肌肉中的成囊期幼虫,为适宜疗程。     

三苯双脒和阿苯达唑治疗感染旋毛虫小鼠的疗效观察

目的观察三苯双脒和阿苯达唑对感染旋毛虫小鼠的疗效。方法将85只昆明小鼠(每鼠感染旋毛虫幼虫100条)分成3组,A组(成虫期,即感染后5d)、B组(幼虫移行期,即感染后15d)和C组(幼虫成囊期,即感染后35d)。A组小鼠35只,均分为7组,三苯双脒和阿苯达唑各治疗3组,两药给药剂量相同,分别为顿服6.25、12.5和25mg/kg,另设1组为对照组。B、C两组各25只小鼠,各均分为5组,三苯双脒和阿苯达唑各治疗2组,两药给药剂量相同,分别为100和200mg/(kg·d),另各设1组为对照组。A组小鼠治疗后2d处死,计数小肠内成虫。B、C两组小鼠连续治疗7d,治疗结束后15d处死,剖取全部膈肌,消化液消化,镜下计数幼虫。计算各组平均虫数和减虫率,统计分析各组治疗效果。结果A组,三苯双脒各组平均成虫数均显著少于对照组(P0.01),减虫率分别为63.3%、86.2%和98.5%;阿苯达唑6.25和12.5mg/kg组的平均成虫数与对照组的差异无统计学意义(P0.05),但25mg/kg组的平均成虫数则少于对照组(P0.05),减虫率为41.2%。B组,两种药物平均虫数都显著少于对照组(P0.01),三苯双脒治疗组减虫率分别为64.4%和89.6%,阿苯达唑组减虫率分别为56.7%和78.4%。C组,仅阿苯达唑200mg/(kg·d)组的平均幼虫(成囊期)数显著少于对照组(P0.01),减虫率为71.8%,其余各组均无效。结论三苯双脒对小鼠旋毛虫成虫和移行期幼虫有较好的疗效,但对成囊期幼虫无效。较大剂量阿苯达唑对小鼠旋毛虫成虫、移行期和成囊期幼虫均有效。     

三苯双脒对小鼠感染3个旋毛虫分离株的疗效观察

目的观察三苯双脒对感染3个分离株旋毛虫小鼠的疗效。方法将144只昆明小鼠随机均分为A组和B组,每组72只。A组小鼠再随机均分为12组,即河南分离株(以下简称河南株)、云南分离株(以下简称云南株)和黑龙江分离株(以下简称黑龙江株)旋毛虫感染组各4组,每组小鼠各感染旋毛虫分离株幼虫200条/只,感染后5 d(即成虫期)分别顿服三苯双脒10、20和30mg/kg,同时设未服药对照组。B组的分组和感染同A组,感染后53 d(即幼虫成囊期)分别灌胃三苯双脒100、200和300mg/(kg.d),1次/d×7d。A组治疗后2d处死,计数小肠内成虫数。B组治疗后10d处死,剖取全部膈肌,经消化液消化后计数幼虫。计算各组平均虫数和减虫率。结果A组中,河南株和云南株各治疗组平均虫数均低于对照组(P<0.01),河南株3个治疗组的减虫率分别为39.0%、57.9%和86.0%,云南株的减虫率分别为34.9%、69.3%和92.2%,分别随服用三苯双脒剂量的增加,减虫率呈增高的趋势,其中30 mg/kg组各有2只鼠被治愈。黑龙江株10 mg/kg组的平均虫数与对照组的差异无统计学意义(P>0.05),其他2个剂量组平均虫数均显著少于对照组(P<0.01),3组的减虫率分别为27.9%、57.4%和60.7%,亦随服用三苯双脒剂量的增加,减虫率呈增高的趋势。B组各治疗组小鼠的平均虫数均低于对照组(P<0.05),河南株的减虫率分别为57.8%、75.4%和87.5%,云南株的分别为74.5%、92.4%和99.1%,黑龙江株的分别为50.5%、53.3%和61.6%。可见3个旋毛虫感染组均随服药剂量的增加,减虫率相应增高。30 mg/kg剂量组中,云南株的减虫率与河南株的和黑龙江株的比较,差异有统计学意义(P<0.05)。结论三苯双脒对小鼠体内3个地域分离株旋毛虫成虫和成囊期幼虫均有一定的疗效,对云南株旋毛虫疗效更明显。     

三苯双脒治疗小鼠不同虫株旋毛虫囊包幼虫感染的效果比较

目的观察不同剂量三苯双脒对小鼠感染不同虫株旋毛虫囊包幼虫的作用效果。方法对河南株、云南株、黑龙江株旋毛虫囊包幼虫感染鼠采用3种剂量的三苯双脒治疗,观察其效果。结果各治疗组小鼠均无不良反应,治疗组平均检虫数均少于对照组(P<0.05),河南株旋毛虫感染组3种剂量治疗后的减虫率分别为87.5%、75.4%和57.8%。云南株旋毛虫感染组减虫率分别为99.1%、92.4%和74.5%。黑龙江株旋毛虫感染组减虫率分别为61.6%、53.3%和50.5%。结论三苯双脒对小鼠感染河南株、云南株、黑龙江株旋毛虫囊包幼虫均有一定的疗效,尤其对云南株旋毛虫囊包幼虫感染的疗效更显著,且随药量的增加减虫率增大。     

6种抗蠕虫药物治疗小鼠尖吻蝮蛇舌状虫感染的疗效观察

目的观察吡喹酮、甲苯达唑、三苯双脒、伊维菌素、蒿甲醚和双氢青蒿素对感染舌状虫小鼠的疗效。方法 35只小鼠每鼠口服感染40个尖吻蝮蛇舌状虫虫卵25～37周后,分为10组,每组2～8只,其中9组分别用吡喹酮500mg/(kg·d)×5d、500mg/(kg·d)×14d,甲苯达唑300mg/(kg·d)×5d,三苯双脒300mg/(kg·d)×5d,伊维菌素8mg/(kg·d)×3d、10mg/(kg·d)×3d和15mg/(kg·d)×14d、蒿甲醚400mg/(kg·d)×5d和双氢青蒿素200mg/(kg·d)×5d治疗,余1组不治疗为对照组。治毕后1～3周剖检小鼠,自腹壁和内脏剥离含有若虫的囊包,观察其在生理盐水中的活动情况并计数。结果感染尖吻蝮蛇舌状虫的小鼠用吡喹酮、甲苯达唑、三苯双脒、伊维菌素、蒿甲醚和双氢青蒿素治疗,各组的平均若虫数与对照组的差异均无统计学意义(P0.05),减虫率为8.3%～35.0%。在剖检受治鼠过程中未查见异常的若虫囊包,若虫的形态、色泽、大小和在生理盐水中的活动均与对照组相仿。结论吡喹酮、甲苯达唑、三苯双脒、伊维菌素、蒿甲醚和双氢青蒿素在所用的实验条件下对小鼠的尖吻蝮蛇舌状虫若虫感染疗效不佳。     

用三苯双脒、吡喹酮和青蒿琥酯临床给药方案治疗感染华支睾吸虫大鼠的研究

目的观察临床应用三苯双脒、青蒿琥酯和吡喹酮的给药方案治疗感染华支睾吸虫大鼠的疗效。方法将临床试用于治疗华支睾吸虫感染的三苯双脒、青蒿琥酯和吡喹酮剂量用不同种属动物等效剂量换算法换算为大鼠用的剂量,并按临床药物联合用药方案,设置了以下的剂量疗程,即三苯双脒16或32mg/(kg·d)×1d、2d和3d(bid),8或16mg/(kg·d)×3d;青蒿琥酯12mg/(kg·d)×3d(tid)和16mg/(kg·d)×3d(bid);吡喹酮143mg/(kg·d)×2或3d(tid),143mg/(kg·d)×2d或3d(bid)和47.7或71.5mg/(kg·d)×3d。151只大鼠(每鼠灌胃感染华支睾吸虫囊蚴50只)分2批,第1批79只大鼠于感染后5周分为13组,每组5～6鼠,其中6组单用三苯双脒、青蒿琥酯或吡喹酮治疗,另7组用三苯双脒与青蒿琥酯或吡喹酮联合治疗,或吡喹酮与青蒿琥酯联合治疗,余8鼠作对照。第2批72只大鼠于感染后6周,分为13组(每组5只),其中7组和6组分别用三苯双脒和吡喹酮的不同剂量疗程治疗,余7鼠作对照。于治疗结束后2周剖杀小鼠,收集胆管和肝组织内的华支睾吸虫,计算各组的平均虫数和减虫率,用非参数统计方法 (Mann-Whitney秩和检验)进行分析。结果第1批试验中,三苯双脒16或32mg/(kg·d)×3d(bid),吡喹酮143mg/(kg·d)×3d(tid)或143mg/(kg·d)×3d(bid)各治疗组的平均虫数均明显低于对照组(P﹤0.01),减虫率为94.2%～96.0%。感染大鼠用青蒿琥酯12mg/(kg·d)×3d(tid)治疗无效,而16mg/(kg·d)×3d(bid)则有57.2%的减虫率,其平均虫数明显低于对照组(P﹤0.05)。三苯双脒16或32mg/(kg·d)×3d(bid)与吡喹酮143mg/(kg·d)×3d(bid),或与青蒿琥酯16mg/(kg·d)×3d(bid)联合治疗组,各组平均虫数均显著少于对照组(P﹤0.01),减虫率为94.2%～99.4%,即联合治疗的疗效与三苯双脒和吡喹酮单用组相仿,但显著高于青蒿琥酯单用组。吡喹酮143mg/(kg·d)×3d(tid)与青蒿琥酯12mg/(kg·d)×3d(tid),或吡喹酮143mg/(kg·d)×3d(bid)与青蒿琥酯16mg/(kg·d)×3d(bid)联合治疗组的减虫率达93.6%～100%。第2批试验中,三苯双脒16或32mg/(kg·d)×2d和3d(bid)治疗组的平均虫数间差异无统计学意义(P0.05),减虫率为86.5%～95.1%,而三苯双脒32mg/(kg·d)×1d(bid)治疗组,减虫率仅为73.0%,但8或16mg/(kg·d)×3d(qd)的减虫率为88.3%～92.6%,吡喹酮143mg/(kg·d)×3d(tid)治疗组的减虫率为96.9%,若同剂量给药2d的减虫率降至63.2%,而47.7mg/(kg·d)×3d(qd)则无效;吡喹酮143mg/(kg·d)×2d和3d(bid)的减虫率相仿,达87.7～95.1%,若同剂量每日顿服,连服3d则无效。结论以人用的三苯双脒、吡喹酮和青蒿琥酯的剂量换算为大鼠用的剂量,并按临床用的疗程治疗感染华支睾吸虫的大鼠,除青蒿琥酯外,均有很好的治疗效果,其中三苯双脒的疗程可由3d缩减为2d。由于单用三苯双脒和吡喹酮已有很高的疗效,故它们之间以及和青蒿琥酯的联合治疗不易显现增效作用。     

不同地理株旋毛虫对小鼠感染性的实验观察

目的观察我国黑龙江、河南及云南省3个地理株旋毛虫对小鼠的感染性。方法取30只昆明小鼠,随机分为3个组,用灌胃感染法分别建立黑龙江株、河南株和云南株旋毛虫动物感染模型,每只灌胃200条肌幼虫。取小鼠膈肌压片,镜下观察各株旋毛虫是否成囊,摸索成囊时间,同时计数膈肌虫荷;随机测量30个囊包的长和宽,计算囊包指数(长/宽);收集小鼠全身各部位肌肉中的幼虫,计算旋毛虫的繁殖力指数(RCI)。结果黑龙江株、河南株及云南株旋毛虫在昆明小鼠体内形成囊包的时间分别为53、40和40d;50mg小鼠膈肌虫荷数分别为(91.8±5.119)条/50mg、(301.8±14.839)条/50mg和(176.4±7.127)条/50mg;囊包指数分别为2.360±0.624、2.385±0.335和1.883±0.401,差异有统计学意义(P<0.05);RCI分别为66.20±1.569、293.84±3.855和154.80±3.894,差异有统计学意义(P<0.05)。结论河南株旋毛虫对小鼠的感染性较黑龙江株和云南株强。     

旋毛虫肌幼虫在感染小鼠体内的分布

目的观察旋毛虫肌幼虫在感染小鼠体内不同部位横纹肌内的分布和密度。方法分别取感染旋毛虫小鼠的舌肌、咬肌、胸肌、腹肌、前肢肌、后肢肌、膈肌和背肌各50mg,肌肉压片镜检。结果膈肌幼虫密度最高,其次为舌肌、胸肌;前肢肌、后肢肌、咬肌、背肌幼虫密度无明显差异,均低于胸肌,腹肌幼虫密度最低。结论感染旋毛虫的小鼠从膈肌取材,检出肌幼虫的阳性率较其他部位高。     

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.     

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。     

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。     

Results of treatment of fistula-in-ano

To evaluate the application of Parks' classification in the management of patients with fistula-in-ano, a study was undertaken to assess the outcome of surgery, especially with respect to the recurrence rate and alteration of continence. A retrospective analysis of 160 consecutive patients who were classified at the time of operation was conducted. The distribution of fistulas was as follows: intersphincteric, 41.9 percent, transsphincteric, 52.1 percent, suprasphincteric, 1.3 percent, extrasphincteric, 0. A horseshoe extension occurred in 8.8 percent of the fistulas and 3.8 percent did not exactly conform to the classification as they were either complex or combinations of more than one type of fistula. The sole immediate postoperative complication was bleeding, which occurred one week postoperatively and ceased spontaneously (0.7 percent). Alteration in continence occurred in 6 percent of patients with 2.6 percent experiencing temporary incontinence to flatus, 1.3 percent to liquid stool, and 0.7 percent to solid stool. Permanent loss of control for flatus occurred in one patient (0.7 percent) and for liquid stool in one patient (0.7 percent). No patients suffered loss of control for solid stool. Recurrence developed in 6.3 percent of patients, all between five and 25 months postoperatively. Classifcation was found to be a useful guide in the operative management of patients with fistula-in-ano. Read at the joint meeting of the American Society of Colon and Rectal Surgeons with the Section of Colo-Proctology, Royal Society of Medicine, and the Section of Colonic and Rectal Surgery, Royal Australasian College of Surgeons, New Orleans, Louisiana, May 6 to 11, 1984.     

Intake of energy drinks in association with alcoholic beverages in a cohort of students of the School of Medicine of the University of Messina

BACKGROUND: Energy drinks (ED) are a widely used group of beverages known for their stimulant effects on central nervous system (CNS). The main components of ED are caffeine, taurine, carbohydrates, glucuronolactone, inositol, niacin, pantenol, and beta-complex vitamins. The studies evaluating the effects of ED describe improvements in attention and/or reaction times and indices of alertness. It has been also shown that combination of caffeine and glucose, fundamental constituents of ED, can ameliorate deficits in cognitive performance and subjective fatigue during extended periods of cognitive demand. Moreover, the associated ingestion of alcohol and ED has recently been observed to be becoming more and more widespread. METHODS: With the aim to know the habits and uses of students, we administered a questionnaire containing questions regarding ED drinking alone or in association with alcoholic beverages. Five hundred students of the School of Medicine of the University of Messina were interviewed, and 450 filled the questionnaire. RESULTS: A total of 56.9% of students declared using ED. A great part of users (48.4%) associate frequently ED and alcohol. In particular, 35.8% of ED + alcohol users have used ED + alcohol more than 3 times in the last month. Distinguishing the users into 2 groups (users of ED + alcohol and users of both ED and ED + alcohol), we observed in the second group a major use of cocktail containing a mix of ED and alcoholic beverages. This difference between the 2 groups is less represented about the ingestion of ED + alcohol in the night. CONCLUSIONS: Our data indicate that association of ED + alcohol is very popular among students. This behavior can be dangerous. In fact, the combination of ED + alcoholic drinks can reduce adversive symptoms of alcohol intoxication including the depressant effects. As consequence, users of ED + alcoholic beverages might not feel the signs of alcohol intoxication, thus increasing the probability of accidents and/or favoring the possibility of development of alcohol dependence.