复方花刺参粘多糖对髂动脉内皮剥脱家兔内膜增生的影响及机制

为了观察复方花刺参粘多糖对动脉损伤家兔内膜增生的影响及其作用机制 ,将雄性新西兰大白兔 37只随机分为正常组、模型组、花刺参组和辛伐他汀组 ,髂动脉损伤术后 6周全部家兔处死 ,取受损动脉 ,HE染色观察动脉形态学改变并图像分析测量动脉内膜、中膜厚度 ,原位杂交检测血小板源生长因子、碱性成纤维细胞生长因子和转化生长因子 β1的表达 ,免疫组织化学染色观察凋亡基因bcl 2和bax表达的改变。结果发现 ,与模型组相比 ,花刺参组和辛伐他汀组动脉内膜厚度及内膜中膜厚度比均明显减小 (P <0 .0 1) ,血小板源生长因子及转化生长因子β1的表达明显降低 (P <0 .0 5 ) ,bax表达明显升高 (P <0 .0 5 ) ,但bcl 2表达无明显差异 ;花刺参组与辛伐他汀组之间各指标均无显著差异。结果提示 ,复方花刺参粘多糖可有效减轻家兔髂动脉损伤血管内膜厚度和管腔狭窄 ,其作用机理与抑制血管平滑肌细胞增殖和促进凋亡有关。     

复方花刺参粘多糖对家兔动脉损伤后血脂及动脉内膜的影响

目的 :探讨复方花刺参粘多糖对家兔动脉损伤后血脂、动脉内膜厚度的影响及作用机制。方法 :雄性新西兰大白兔 37只随机分为假手术组、模型组、花刺参组和辛伐他汀组 ,髂动脉损伤术 6周处死全部家兔取血及受损动脉 ,检测各组家兔的血清脂质浓度 ,苏木精 伊红染色观察动脉形态学改变 ,图像分析测量动脉内膜、中膜厚度 ,原位杂交检测生长因子 [转化生长因子 β1(TGF β1)、成纤维细胞生长因子 (bFGF)和血小板衍生长因子(PDGF)表达。结果 :花刺参组血清总胆固醇 (TC)及低密度脂蛋白胆固醇 (LDL C)浓度显著低于模型组 (P <0 .0 5 ) ;花刺参组和辛伐他汀组动脉内膜厚度、内膜 /中膜厚度比及PDGF及TGF β1的表达明显少于模型组 (P<0 .0 1) ;花刺参组与辛伐他汀组各项参数之间比较均差异无统计学意义。结论 :复方花刺参粘多糖能有效的调整血脂 ,减轻家兔髂动脉损伤血管内膜厚度和管腔狭窄 ,其作用可能与抑制生长因子的合成与分泌有关     

非洛地平对家兔血管成形术后内皮功能及内膜增殖的影响

目的：探讨非洛地平对家兔血管成形术后内皮功能及内膜增殖的影响。方法：日本大耳白兔３６只,高脂喂养４周后用球囊导管剥脱腹主动脉内皮,再高脂喂养４周后,对动脉粥样硬化部位行血管成形术,３０只成功的动物随机分为对照组、高脂组和治疗组（非洛地平）,继续喂养４周后采集局部血管行病理形态学分析,并观察实验前后各组血清脂质、一氧化氮及血浆内皮素－１的改变。结果：治疗组血管内膜面积与中膜面积之比及内膜面积均降低。各组高脂饮食后血清总胆固醇、甘油三酯和血浆内皮素－１均明显升高,而血清一氧化氮明显下降;１２周治疗组血浆内皮素－１明显降低,而血清一氧化氮水平明显升高。结论：非洛地平具有抑制家兔血管成形术后内膜增殖和保护内皮功能的作用。     

动脉粥样硬化形成和消退中平滑肌细胞定量研究

用网格交点计数法测量了动脉粥样硬化(AS)形成组和消退组及对照组的平滑肌细胞(SMC)胞质内的超做结构。AS形成组内膜或中膜第一层(靠内弹性膜侧)SMC跑质中肌丝减少,而高尔基体、粗面内质网和线粒体增多,AS消退组的肌丝、高尔基体和粗面内质网与对照组相比没有明显差别。结果提示:AS形成组SMC由收缩型向合成型方向转变,可能与SMC增生和转移及与分泌细胞外基质有关;AS消退组SMC由合成型向收缩型转变,可减少细胞外基质的分泌。     

半边莲不同组分对内皮细胞内皮素及内皮源一氧化氮合酶代谢的影响

为了探讨半边莲对动脉内皮保护作用的有效成分 ,提取半边莲两种不同组分用于高脂血症大鼠 ,观察对动脉内皮细胞内皮素和内皮源一氧化氮合酶代谢以及对动脉内皮功能和形态的影响。结果发现 ,高脂血症大鼠应用半边莲B0 0 1组分 6 0天后 ,血浆内皮素浓度和动脉内皮细胞内皮素阳性细胞率明显低于高脂未用药组 (P <0 .0 5 ) ,血浆内皮源一氧化氮合酶浓度显著高于高脂未用药组 (P <0 .0 5 ) ,且动脉内皮损伤减轻 ,但血脂无明显变化。应用半边莲A0 0 1组分的高脂血症大鼠血脂浓度、内皮素和内皮源一氧化氮合酶无明显变化。结果提示 ,半边莲B0 0 1使高脂血症时内皮细胞、内皮素合成及释放减少 ,并可促进内皮源一氧化氮合酶的合成 ,缓解高脂血症对血管内皮的持续损伤。     

射频球囊成形术对血管平滑肌细胞的影响

本研究将射频球囊成形术应用于动脉粥样硬化狭窄模型，观察球囊表面电极直接释放射频能量并结合扩张压力对血管平滑肌细胞增殖作用的影响。另一组利用相同模型行单纯球囊成形术作为对照研究，结果显示，射频球囊成形术后血管平滑肌细胞器变性，线粒体及粗面内质网密度降低，细胞代谢障碍，合成型减少，部分血管平滑肌细胞变性坏死，新生内膜面积减少，对防止血管成形术后再狭窄有一定意义。     

卡托普利对动脉腔内成形术局部平滑肌细胞超微结构影响的实验研究

本实验在建立兔右髂动脉粥样硬化狭窄模型的基础上,观察卡托普利对成形术局部血管内膜平滑肌细胞(SMCs)超微结构的影响.结果表明,扩张术后1～2周血管内膜SMCs.由收缩型转变为合成型;卡托普利可使SMCs胞浆中与合成及增生功能有关的细胞器(粗面内质网和线粒体)明显减少,单位体积SMCs胞浆内细胞器作密度显著降低.提示卡托普利可有效抑制SMCs增殖程度,对防止再狭窄发生有重要意义.     

花刺参粘多糖对血小板源生长因子BB诱导的大鼠血管平滑肌细胞增殖和凋亡的影响

目的观察花刺参粘多糖对血小板源生长因子BB诱导的大鼠血管平滑肌细胞增殖和凋亡的影响,以探讨花刺参粘多糖抗动脉粥样硬化、预防经皮腔内冠状动脉成形术后再狭窄的可能机制。方法组织块贴片法体外原代培养大鼠血管平滑肌细胞,细胞增殖采用四甲基偶氮唑盐、流式细胞细胞周期分析;流式细胞术、TUNEL法观察细胞凋亡。结果血小板源生长因子BB刺激后可促进血管平滑肌细胞增殖,抑制其凋亡;花刺参粘多糖则呈浓度依赖性地逆转此作用,光密度值由0.406±0.003减少到0.187±0.017(P<0.01),G0/G1期细胞比例由77.4%±5.7%增加到88.1%±5.3%(P<0.05),细胞凋亡率由8.6%±2.3%增加到22.6%±2.3%(P<0.05),凋亡细胞比例由2.7%±0.4%增加到10.1%±0.9%(P<0.01)。结论花刺参粘多糖可抑制血小板源生长因子BB诱导的血管平滑肌细胞增殖,促进其凋亡,这可能对延缓动脉粥样硬化的发生发展、防止经皮腔内冠状动脉成形术后再狭窄的发生起到一定作用。     

脑得生胶囊对家兔血管成形术后内皮功能和内膜增殖的影响

目的 探讨脑得生胶囊对家兔血管成形术后内皮功能和内膜增殖的影响.方法 雄性大耳白兔30只,随机分成4组:对照组(n=6),拉伤组(n=8),高脂组(n=8),脑得生组(n=8).采用高胆固醇喂养加腹主动脉内皮剥脱制作血管狭窄模型,之后行血管球囊扩张成形术.于术后4 w处死动物,取血管成形术部位血管标本,用免疫组化测定增殖细胞核抗原(PCNA)的表达水平.并分别于实验初、实验末兔耳缘静脉采血检测一氧化氮(NO)、内皮素(ET-1)浓度.结果 高脂组内膜增生最明显,内膜面积最大而管腔面积最小;脑得生组内膜面积较高脂组明显减小,管腔面积明显扩大.高脂组血清总胆固醇(TC)、低密度脂蛋白(LDL-C)和ET-1均明显升高,而血清NO明显下降;脑得生组血浆TC、LDL-C和ET-1明显降低,而血清NO水平明显升高.免疫组化染色:与高脂组比较,脑得生组PCNA的表达水平显著减少,有显著性差异(P＜0.05).结论 脑得生胶囊具有抑制家兔血管成形术后内膜增殖和保护血管内皮功能的作用.     

辛伐他汀对血管平滑肌细胞增殖和迁移的影响

目的观察辛伐他汀对血管平滑肌细胞增殖、迁移及血管内皮生长因子表达的影响。方法体外培养大鼠原代血管平滑肌细胞,体内建立大鼠动脉粥样硬化血管损伤模型,分为正常对照组、动脉粥样硬化损伤组、低剂量和高剂量辛伐他汀组。4周后处死动物,酶法测定血脂水平,检测胸主动脉和左颈总动脉内膜/(内膜 中膜)比值,免疫组织化学和逆转录聚合酶链反应法检测血管内皮生长因子的表达。结果辛伐他汀对血管平滑肌细胞的增殖和迁移无双向调节作用。小剂量辛伐他汀对血管平滑肌细胞的增殖和迁移无促进作用,大剂量辛伐他汀抑制血管平滑肌细胞的增殖和迁移,且随着时间延长和浓度增加其抑制作用增强,这种作用不依赖辛伐他汀的调脂性。辛伐他汀能减少血管平滑肌细胞血管内皮生长因子的表达,且高浓度的辛伐他汀显著减少血管内皮生长因子的表达。结论辛伐他汀可能通过减少血管平滑肌细胞血管内皮生长因子的表达来抑制血管平滑肌细胞的增殖和迁移。     

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。     

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.     

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。     

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.