褪黑素对急性胰腺炎相关性肺损伤中趋化因子MIP-2表达的影响

目的 观察褪黑素(MT)对ANP大鼠肺组织趋因子巨噬细胞炎性蛋白-2(MIP-2)表达的影响,探讨MIP-2在ANP相关肺损伤发病机制中的作用.方法 35只SD大鼠随机分为假手术组(SO组),ANP 3h、6h、12h组和MT 3h、6h、12h组,每组5只.采用4%牛磺胆酸钠胰胆管逆行注射制备ANP动物模型,MT 组在ANP诱导前30min腹腔注射MT20mg/kg体重.检测血淀粉酶,观察肺组织病理学改变,采用实时定量RT-PCR法和免疫组化检测肺组织中MIP-2 mRNA和蛋白的表达.结果 与SO组相比,ANP3h、6h和12h组肺组织MIP-2 mRNA表达分别增加48%、137%和230%.ANP组MIP-2 蛋白表达量分别为3.42±0.84,5.80±0.55和6.40±0.45.MT干预组肺组织损伤得到改善,MIP-2 m RNA 表达分别为ANP相应时间点的87%,77%和84%,MIP-2蛋白表达分别为2.20±0.84,4.20±0.45和5.20±0.50,与ANP相应时间点比较,相差显著(P＜0.05).结论 MIP-2 在ANP相关肺损伤发病中起一定作用,MT 可能通过下调MIP-2的表达以减轻ANP相关肺损伤的程度.     

PPAR-γ激动剂对急性坏死性胰腺炎大鼠肺损伤的作用

目的 探讨过氧化物酶体增殖物激活受体γ(PPAR-γ)激动剂罗格列酮对ANP大鼠肺损伤的作用及其机制.方法 雄性Wistar大鼠54只,按完全随机法分为假手术组(SO组)、ANP组、罗格列酮组.胆胰管逆行注射5%牛磺胆酸钠制备ANP模型.SO组、ANP组在造模前30 min股静脉注射10%DMSO(0.2 ml/100 g体重);罗格列酮组则注射等量10%DMSO溶解的罗格列酮(6 mg/kg体重).术后3 h、6 h、12 h分批剖杀,每个时间点6只.检测血清淀粉酶、肺组织髓过氧化物酶(MPO)、肺湿干重比、支气管肺泡灌洗液(BALF)蛋白含量.取胰头部胰腺组织和肺组织行病理学检查.RT-PCR检测肺组织TNF-α mRNA和ICAM-1 mRNA的表达.结果 ANP组血淀粉酶、肺MPO、湿干重比、BALF蛋白含量、胰腺及肺病理分值、肺脏TNF-α mRNA和ICAM-1 mRNA的表达水平均随时间延长而逐渐升高,12 h时分另0为(5353.0±728.2)U/L、(1.12±0.14)U/g、3.00±0.14、(0.438±0.056)g/L、11.17±0.93、8.17±0.75、0.57±0.03和1.53±0.08,均明显高于SO组(P<0.05或P<0.01).罗格列酮12 h组上述指标分别为(2847.4±841.0)U/L、(0.84±0.06)U/g、2.13±0.36、(0.283±0.078)g/L、7.75±0.27和4.33±0.82、0.26±0.04和0.84±0.02,均明显低于ANP 12 h组(P<0.05或P<0.01),但仍高于SO组(P<0.05或P<0.01).结论 罗格列酮对ANP大鼠胰腺及肺损伤具有一定程度保护作用,其机制可能与抑制肺组织TNF-α、ICAM-1 mRNA的表达有关.     

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.     

厚朴酚对大鼠坏死性胰腺炎肺损伤的保护作用

目的:观察厚朴酚(magnolol,Mag)对大鼠急性坏死性胰腺炎(ANP)肺组织中核因子-kB(NF-kB)、白介素-10(IL-10)和肿瘤坏死因子(TNF-a)表达的影响,以探讨厚朴酚对ANP急性肺损伤的保护作用.方法:以50g/L牛磺胆酸钠逆行胆胰管注射制备大鼠ANP模型,SD大鼠56只随机分为假手术(SO)组,ANP模型组,及Mag治疗组.以荧光定量PCR检测不同时间(6,12,24h)肺组织中NF-kB、TNF-a和IL-10的基因表达,同时检测各组血清淀粉酶(Amy)的水平,并观察胰腺和肺的组织病理学改变.结果:与SO组相比,ANP组肺组织中的NF-kB,TNF-a,IL-10mRNA表达量及血清Amy显著增加(P<0.01),其中NF-kB,TNF-amRNA及Amy以12h的升高最明显(P<0.01),IL-10mRNA随ANP时间的进展表达逐渐增加(6,12,24h分别为0.20±0.05,0.27±0.07,0.45±0.20).与ANP各组比较,Mag各组NF-kBmRNA,TNF-amRNA及Amy表达量下降,也以12h下降最显著(分别为1.30±0.14vs1.84±0.56,0.41±0.19vs0.72±0.36,P<0.05;104576±24886nkat/Lvs188621±23747nkat/L,P<0.01),IL-10mRNA的改变无统计学意义(P>0.05).Mag治疗组肺组织学改变较ANP组明显减轻,胰腺组织学损害无明显改善.结论:NF-kB和TNF-a是ANP发生急性肺损伤的重要炎症因子,Mag能抑制其在ANP大鼠肺组织中的表达,对ANP合并急性肺损伤有一定的治疗作用.     

急性坏死性胰腺炎胰腺组织中褪黑激素受体表达及褪黑激素干预作用

目的 探讨急性坏死性胰腺炎(ANP)胰腺组织中褪黑激素受体MT1表达及褪黑激素(MT)干预作用.方法 54只SD大鼠随机分为假手术组(SO组)、急性坏死性胰腺炎组(ANP组)、MT干预组(MT组),每组18只.应用胰胆管逆行注射牛磺胆酸钠的方法诱导ANP模型,MT组于诱导模型前30 min腹腔注射MT.术后4 h、8 h和12 h分批处死大鼠(每个时间点6只),以免疫组化和实时定量PCR分别检测胰腺组织中MT1蛋白及MT1 mRNA的表达;检测血清淀粉酶、胰腺组织中丙二醛(MDA)、超氧化物歧化酶(SOD)及TNFα的含量,并行胰腺病理检查.结果 (1)ANP组胰腺病理损伤呈进行性加重,MT组胰腺病理损伤较ANP组明显减轻(P＜0.05).(2)淀粉酶、MDA、TNFα水平在ANP组较S0组明显增高(P＜0.05或P＜0.01),而MT组较相应时间点ANP组显著降低[12 h,(2348.00±278.90)U/L比(3194.83±538.10)U/L,(2.255±0.472)μmol/L比(2.960±0.722)μmol/L,(102.929±29.399)ng/L比(378.544±183.454)ng/L,P＜0.05].SOD水平在ANP组各时点较SO组显著降低(P＜0.01),而MT组较ANP组显著升高[12 h,(11.448±1.594)U/L比(8.427±1.950)U/L,P＜0.05].(3)与SO组相比,MT1蛋白及MT1 mRNA表达在ANP组胰腺组织中明显下降(P＜0.05),且随ANP病变加重表达减弱,而MT组表达较ANP组明显增多.结论 MT干预可提高SOD活力,降低MDA、TNFα水平,故能显著减轻ANP时胰腺病理损伤,MT1在ANP发病机制中可能具有重要作用,MT对ANP中的干预作用可能与上调胰腺组织中MT1的表达有关.     

单核细胞趋化蛋白1在重症急性胰腺炎相关肺损伤中的作用

目的 探讨单核细胞趋化蛋白1(MCP-1)在急性坏死性胰腺炎(ANP)早期并发急性肺损伤(ALI)发病机制中的作用.方法 按数字表法将40只SD大鼠随机分为对照组和ANP 3、6、12 h组,每组10只.采用15%左旋盐酸精氨酸2.0 mg/g体重腹腔注射方法制作大鼠ANP模型,观察胰腺及肺组织病理学改变,检测肺湿/干重比,RT-PCR检测肺组织MCP-1 mRNA的表达.结果 腹腔注射左旋盐酸精氨酸后大鼠胰腺发生出血、坏死,符合ANP病理改变.ANP组肺组织明显水肿,3、6、12 h的病理评分分别为3.75±0.58、5.50±0.63、5.86±0.54;肺湿/干重比为4.85±0.38、4.97±0.47、5.03±0.46;肺组织MCP-1 mRNA表达量为0.36±0.08、0.56±0.15、0.72±0.21.均较对照组的0.12±0.05、4.32±0.33、0.21±0.05显著升高(P＜0.05或＜0.01),且MCP-1 mRNA表达与肺湿/干重比及肺组织损害程度均呈正相关(r=0.75,r=0.89,P＜0.05).结论 ANP早期肺组织MCP-1 mRNA表达上调,并在ANP并发的ALI中发挥重要作用.     

JNK信号通路在急性坏死性胰腺炎大鼠相关性肺损伤中的作用

目的 探讨JNK信号通路在重症急性胰腺炎相关性肺损伤中的作用.方法 24只大鼠按数字表法随机分为假手术组和急性坏死性胰腺炎(ANP)组,采用胆总管逆行注射5％牛磺胆酸钠建立ANP大鼠模型.制模后12、24h处死大鼠,取胰腺、肺组织行常规病理检查;采用ELISA法检测肺组织TNF-α和IL-1β含量;实时PCR和蛋白质印迹法检测肺组织JNK mRNA和蛋白的表达.结果 ANP 组大鼠胰腺组织出血、坏死,大量炎细胞浸润;肺组织水肿,肺实变、间质水肿,炎症细胞浸润.ANP组24h时肺组织TNF-α、IL-1β含量及JNK mRNA、JNK蛋白、磷酸化JNK表达量分别为(374.3±124.0)pg/ml、(649.0±114.9) pg/ml、2.57±0.76、1.40±0.81、0.81±0.20,均较假手术组的(218.2±68.4)pg/ml、(524.3±58.4) pg/ml、1.03±0.11、0.32 ±0.11、0.32 ±0.11显著增加(P值均＜0.05).结论 JNK信号通路在实验性ANP相关肺损伤中起着一定作用.     

E-选择素在大鼠急性坏死性胰腺炎肺损伤组织的动态表达及其意义

目的 探讨E-选择素在实验性急性坏死性胰腺炎(ANP)大鼠肺组织的表达及其意义.方法 按随机数字法将大鼠分为对照组及ANP组.采用逆行胆胰管注射5％牛磺胆酸钠制作大鼠ANP模型,术后3、6、12、24 h分批处死动物.检测血清淀粉酶、白蛋白及Ca2+水平,计算肺湿/干重比,常规行胰腺和肺组织病理检查并评分,实时荧光定量PCR及免疫组化法检测大鼠肺组织E-选择素mRNA和蛋白表达.结果 ANP 6 h组大鼠血淀粉酶、胰腺及肺病理评分、肺湿/干重比分别为(3978±476) U/L,(8.22±0.63)分、(12.31 ±1.58)分、5.21 ±0.20、均显著高于对照组的(843±90) U/L、(0.22±0.36)分、(0.13±0.34)分、4.46 ±0.17(P＜0.05或＜0.01);血清白蛋白水平为(12.9±1.0)g/L,显著低于对照组的(15.6 ±0.7)g/L(P ＜0.01);12 h时的血Ca2+水平为( 2.33±0.15)mmoL/L,显著低于对照组的(2.57 ±0.23) mmoL/L(P ＜0.01).E-选择素定位于血管内皮细胞胞膜及胞质.ANP 6 h组大鼠肺组织E-选择素mRNA与蛋白表达显著高于对照组(3.51 ±0.45比0.95 ±0.16;0.174 ±0.019比0.060±0.006,P值均＜0.01).结论 ANP大鼠并发肺损伤时肺组织的血管内皮细胞E-选择素表达呈时间依赖性上调,并参与白细胞的附壁及外渗,促进肺损伤.     

巨噬细胞移动抑制因子在大鼠急性坏死性胰腺炎肺损伤中的作用

目的 检测急性坏死性胰腺炎(severe acute pancreatitis,ANP)大鼠肺组织巨噬细胞移动抑制因子(MIF)mRAN表达及TNF-α含量,探讨它们在ANP肺损伤中的作用机制.方法 40只SD大鼠随机分成对照组及ANP 3、6、12 h组.采用5%牛磺胆酸钠(0.1 ml/100 g体重)胆胰管逆行注射方法制备ANP模型.取血检测血清淀粉酶.取胰腺组织和肺组织行病理学检查,并称重计算其湿/干重比.采用RT-PCR法检测肺组织MIF mRNA表达,放免法测定肺组织TNF-α含量.结果 ANP组血淀粉酶、胰腺和肺组织湿/干重比显著升高,病理损伤随时间延长逐渐加重.ANP 3、6、12 h组肺组织TNF-α含量分别为(0.69±0.07)ng/ml、(1.64±0.10)ng/ml和(0.92±0.11)ng/ml;MIF mRNA表达量分别为1.97±0.09、2.55±0.23、3.29±0.26,均显著高于对照组的(0.19±0.06)ng/ml和1.21±0.34(P值均<0.01).肺组织MIFmRNA表达与肺组织病理损伤、肺湿干重比、TNF-α含量均呈正相关,相关系数分别为r=0.637、r=0.684、r=0.858,P值均<0.01.肺组织TNF-α含量与肺损伤、肺湿/干重比均呈正相关,相关系数分别为r=0.540和r=0.421,P值均<0.01.结论 ANP大鼠肺组织MIFmRNA过表达,TNF-α含量显著增加,它们共同参与肺损伤的发生.     

硫氧还蛋白-1 在急性坏死性胰腺炎大鼠中的表达及褪黑素对其的影响

目的 观察硫氧还蛋白-1(TRX-1)在急性坏死性胰腺炎(ANP)大鼠胰腺组织的表达和褪黑素干预对其的影响.方法 72只雄性SD大鼠随机分成ANP组、褪黑素组和对照组,每组24只.以腹腔注射6%L-Arginine 25 mL/kg体重3次、每次间隔1 h的方法制备ANP模型.褪黑素组在制模前30min腹腔注射0.25%褪黑素20 ml/kg体重;ANP组和对照组大鼠腹腔注射等容积生理盐水.术后6、12、24 h分批处死大鼠.抽血测定血清淀粉酶含量;取胰腺组织行病理学检查,并评分;检测胰腺组织丙二醛(MDA)、髓过氧化酶(MPO)含量;免疫组化检测胰腺组织TRX-1蛋白表达;RT-PCR检测胰腺组织TRX-1 mRNA的表达.结果 ANP组12 h点血清淀粉酶、胰腺组织MDA和MPO以及TRX-1 mRNA和蛋白表达水平分别为(3 012±1 425)u/L、(4.13±1.85)nmol/mg prot、(7.45±1.26)nmol/mg prot、0.68±0.18、66.8±8.1;褪黑素组分别为(1 835±499)U/L、(3.03±2.12)nmol/mg prot、(5.32±1.06)nmml//mgprot、0.50±0.09、80.29±8.14,两组比较均有显著差异(P<0.05).褪黑素组胰腺TRX-1 mRNA和蛋白表达峰值从ANP组的制模后12 h提前到制模后6 h.结论 ANP大鼠胰腺组织TRX-1 mRNA和蛋白表达增高;褪黑素干预能促进胰腺组织早期表达TRX-1 mRNA和蛋白,减轻胰腺组织的损伤.     

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.