干细胞因子对糖尿病小鼠结肠Cajal间质细胞的干预效应

目的:探讨外源性干细胞因子(stem cell factor,SCF)能善糖尿病(diabetes mellitus,DM)小鼠结肠Cajal间质细胞(interstitial cells of Cajal,ICC)的异常病变.方法:DMd、鼠一次性ip链脲佐菌素(STZ,150mg/kg)造模,将♂ C57/BL6小鼠分为正常对照组(control组)、糖尿病组(DM组)、糖尿病 外源性SCF组(DM SCF组):DM SCF组ip SCF0.2 μg/(kg穌),control组和DM组每天ip等量的磷酸盐缓冲液(pH=7.4),干预6 wk后处死所有小鼠,以Western blot检测远端结肠组织中SCF的表达情况,以免疫组化、透射电镜和Western blot观察远端结肠ICC的变化.结果:DM小鼠远端结肠组织中SCF水平明显降低(178.97±13.51 vs 200.25±16.48,P<0.05),且伴结肠组织中ICC数量减少(72±10 vs 102±12.P＜0.05)、超微结构严重破坏.DM鼠给予外源性SCF干预后,结肠组织中SCF表达(210.14±11.8)上调(P＜0.05),且ICC的数量(87±10,P＜0.05)和超微结构显著改善.结论:外源性SCF对糖尿病相关的结肠ICC异常病变有一定改善或逆转作用.     

干细胞因子对糖尿病结肠Cajal间质细胞的影响

目的 探讨糖尿病(DM)小鼠干细胞因子(SCF)对结肠Cajal间质细胞(ICC)异常的影响.方法 40只雄性C57/BL6小鼠分为正常对照组,DM组、正常+抗-SCF组、DM+SCF组,每组10只.DM成模后6周处死小鼠,以流式细胞仪、透射电镜、Western印迹法观察近端结肠组织中ICC的变化,以Western印迹、酶联免疫吸附实验(ELISA)检测结肠组织和血清中SCF的表达情况.结果 DM小鼠血清和近端结肠组织中SCF均明显降低,伴有结肠中ICC数量减少、超微结构显著破坏;正常+抗-SCF组,血清和近端结肠组织中SCF均明显降低,并伴有结肠中ICC数量减少、超微结构显著破坏(类似DM组);DM+SCF干预后,血清和近端结肠组织中SCF水平增高,ICC的数量以及超微结构病变得到显著改善.结论 DM小鼠血清和近端结肠组织中SCF水平的下降,可能是DM结肠中ICC数量减少和超微结构破坏的原因;外源性SCF能改善DM相关的胃肠道ICC病变.     

糖尿病结肠动力障碍时Cajal间质细胞和干细胞因子的变化以及胰岛素的干预效应

Cajal间质细胞（ICC）异常可能是糖尿病胃肠动力障碍的重要原因之一。目的：观察糖尿病结肠慢传输型动力障碍大鼠ICC及其Kit受体配体干细胞因子（SCF）的变化，以及胰岛素干预对结肠动力障碍和ICC的影响。方法：雄性Sprague—Dawley大鼠分为正常对照组、糖尿病模型组和不同剂量胰岛素（每天8、12、16U／kg）干预组。于成模第6、8、10周时分批处死各组大鼠，以免疫组化染色、蛋白质印迹法和电子显微镜观察近端结肠组织ICC的变化．以酶联免疫吸附测定（ELISA）和荧光定量聚合酶链反应（qPCR）检测血清和结肠组织SCF的表达。结果：糖尿病模型大鼠胃肠推进率显著降低，近端结肠组织ICC数量减少，超微结构破坏，结肠组织可溶型SCF（S-SCF）mRNA表达和血清S-SCF、胰岛素水平降低。小剂量胰岛素干预可显著改善糖尿病大鼠的胃肠推进率，增加ICC数量，逆转其超微结构改变：中、大剂量胰岛素干预则无明显作用。结论：糖尿病大鼠胰岛素分泌减少，使S-SCF表达降低，引起结肠组织ICC数量减少．结构破坏，可能是结肠慢传输型动力障碍的发生基础之一。小剂量胰岛素可改善糖尿病大鼠的ICC病变和结肠动力障碍。     

胰岛素样生长因子1对大鼠结肠平滑肌细胞中干细胞因子表达的影响

目的:探讨胰岛素样生长因子1(IGF-1) 对大鼠结肠平滑肌细胞(SMC)表达干细胞因子(SCF) 的影响. 方法:酶解法分离培养SD 大鼠结肠S M C、α-actin 免疫荧光鉴定,然后将大鼠结肠SMC 随机分为IGF-1 不同浓度(0 、5、10 、50 、100 、150 μg/L) 、时间(0 、8、16 、24 、48 h) 及IGF-1α受体(IGF-1Rα)抗体(0 、50 、100 、150 μg/L) 干预组;Western blot 、RT-PCR 法检测SMC合成SCF 的变化. 结果:低剂量IGF-1(5 、10 μg/L) 对SCF 蛋白和mR N A表达无影响(P >0.05),中高剂量IGF-1(50 、100 、150 μg/L) 诱导其表达增加(均P <0.05),100 μg/L可能为体外最大有效浓度(0.820±0.061 vs 0.167±0.015;1.269± 0.219 vs 0.560±0.023,均P <0.05),且其促SCF 蛋白和mRNA合成的最高峰在第16 小时(0.420 ±0.034 vs 0.209±0.001;1.407±0.133 vs 0.477±0.041,均P <0.05),IGF-1Rα抗体可抑制SCF 蛋白和mRNA合成,抑制作用呈浓度依赖性(P <0.05). 结论:IGF-1 能通过作用于SMC上的IGF-1 受体刺激大鼠结肠SMC内SCF 的表达.     

白细胞介素6对豚鼠离体近端结肠平滑肌收缩的影响

目的:研究白细胞介素6(IL-6)对豚鼠近端结肠平滑肌的影响及其机制.方法:观察IL-6对结肠收缩的影响;用河豚毒素(TTX)阻断肠神经后观察不同浓度IL-6对结肠平滑肌收缩的影响;损伤Cajal间质细胞(ICC)后观察IL-6对结肠平滑肌收缩的影响.结果:在带有ICC的近端结肠纵行肌加入IL-6后,结肠平滑肌的收缩振幅增加和频率加快,呈浓度依赖性:加入TTX后,收缩的幅度和频率,同拮抗前相比分别降低和减慢(0.206±0.027 g vs 0.300±0.039 g;9.770±1.711 s vs 8.483±1.113 s:P<0.01,P<0.05):TTX阻断后加入IL-6(80μg/L),振幅增加和频率加快(P<0.01,P<0.05):破坏结肠ICC,收缩幅度和频率分别与损伤ICC后加入IL-6无显著性差异(80μg/L),而与正常结肠收缩振幅和频率有显著性差异(P<0.01).结论:IL-6对豚鼠近端结肠平滑肌的收缩活动有兴奋作用,其兴奋效应主要是通过肠神经元介导.ICC是IL-6对平滑肌兴奋途径的一个不可缺少的中间环节.     

番石榴叶提取物对三硝基苯磺酸诱导大鼠结肠炎结肠组织的保护作用

目的:研究番石榴叶提取物对大鼠结肠炎组织损伤的保护作用及其机制.方法:用健康Wistar大鼠建立大鼠结肠炎模型,灌胃用药2 wk后,评价大鼠结肠黏膜损伤指数(CMDI),检测结肠组织髓过氧化物酶(MPO)及超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量和细胞肿瘤因子(TNF)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)水平.结果:不同剂量番石榴叶提取物(200,500,800 mg/kg)灌胃均能不同程度降低模型大鼠CMDI(2.62±0.47,2.06±0.54,1.83±0.43 vs 3.15±0.39,P＜0.05,P＜0.01,P＜0.01),MPO活性(2240.78±479.26,2078.42±377.91,1748.85±236.71 nkat/g vs 2695.37±624.79 nkat/g P＜0.05,P＜0.01,P＜0.01),减少MDA含量(2.16±0.41,1.97±0.35,1.96±0.30,P＜0.05,P＜0.01,P＜0.01),提高SOD活性(3618.06±538.44,3756.92±577.45,4197.51±375.74 nkat/g vs 2663.37±603.79,P＜0.05,P＜0.01,P＜0.01),降低TNF(2.65±0.40,2.51±0.47,2.21±0.41 μg/L vs 3.30±0.63 μg/L,P＜0.05,P＜0.01,P＜0.01)、IL-8(1.20±0.33,1.05±0.24,0.92±0.13 μg/L vs 1.53±0.38 μg/L,P＜0.05,P＜0.01,P＜0.01)、IL-10(39.36±9.65,50.26±11.32.59.68±13.65 ng/L vs 30.74±12.91 ng/L,P＜0.05,P＜0.01,P＜0.01)水平,且与用药剂量呈一定量效关系.结论:番石榴叶提取物通过拮抗氧化、免疫调节、损伤修复作用缓解结肠炎大鼠炎症反应,减轻结肠损伤.     

黄芪建中汤加味对糖尿病胃轻瘫大鼠的疗效及其对胃窦SCF-Kit信号途径的影响研究

目的分析黄芪建中汤加味对糖尿病胃轻瘫(diabetic gastroparesis, DGP)大鼠的疗效及其对胃窦干细胞因子(stem cell factor, SCF)-Kit信号途径的影响.方法选取SPF级Wistar雄性大鼠75只,随机数字表法降低大鼠分成5组,模型组、正常组、阳性对照组、黄芪建中汤加味低剂量组及黄芪建中汤加味高剂量组,各15只,除正常组外,其他各组大鼠制备DGP模型,造模后阳性对照组大鼠灌胃0.78 g/mL的吗丁啉混悬液,黄芪建中汤加味低剂量组、黄芪建中汤加味高剂量组分别灌胃0.78 g/mL、3.12 g/mL的黄芪建中汤加味药液,正常组和模型组灌胃生理盐水,各组大鼠给药体积为10 mL/kg,持续灌胃6 wk;观察各组大鼠一般状况、体重、胃拍空率、血清可溶型SCF(soluble SCF, sSCF)、胃泌素(gastrin, GAS)、胃动素(motilin, MLT)含量及胃窦组织内Cajal间质细胞(interstitial cells of Cajal, ICC)含量、c-kit、膜结合型SCF(membrane-bound SCF, mSCF)蛋白表达量.结果和正常组相比,模型组大鼠血糖、GAS及MLT含量上升,可溶型SCF(soluble SCF, sSCF)含量、胃排空率下降;和模型组相比,阳性对照组、黄芪建中汤加味低剂量组及黄芪建中汤加味高剂量组大鼠血糖、GAS及MLT含量下降,sS CF含量、胃排空率上升,差异有统计学意义(P0.05);和正常组相比,模型组大鼠胃窦组织内c-kit、mSCF蛋白表达下降;和模型组相比,阳性对照组、黄芪建中汤加味低剂量组及黄芪建中汤加味高剂量组大鼠c-kit、mSCF蛋白表达上升,差异有统计学意义(P0.05);和阳性对照组相比,黄芪建中汤加味低剂量组及黄芪建中汤加味高剂量组大鼠c-kit、mSCF蛋白表达上升,但差异无统计学意义(P0.05).结论黄芪建中汤加味经过提升mSCF蛋白表达,上调SCFKit信号途径,使DGP大鼠胃窦组织内ICC含量增大,改善其胃起搏功能,胃动力增强.     

血红素氧合酶的干预对糖尿病大鼠结肠动力障碍的影响

目的:探讨血红素氧合酶(heme oxygenase,HO)的干预对糖尿病(diabetes mellitus,DM)大鼠结肠动力障碍的影响.方法:链脲佐菌素ip建立DM模型,饲养6 wk时以碳沫推进实验证实DM大鼠存在胃肠慢传输运动后,所有大鼠分为正常对照组、DM未干预组、DM Hemin组[予HO诱导剂正铁血红素(Hemin)]及DM ZnPP组[予HO阻滞剂锌原卟啉(zinc protoporphyrin Ⅸ,ZnPP Ⅸ)];监测体质量、血糖.饲养9 wk时再测胃肠推进率,离体肌条实验记录结肠平滑肌条自发收缩反应及对Ach的反应性,Western blot及免疫组化检测近、远端结肠HO的表达.结果:6 wk时DM大鼠胃肠慢传输运动模型建立.HO干预对DM大鼠体质量、血糖无影响(P＞0.05).9 wk时Western blot示DM未干预组(1.20±0.09)、DM Hemin组(1.08±0.11)及DM ZnPP组(1.10±0.08)近端结肠HO-2表达无显著差异(P＞0.05),但均较正常对照组(1.66±0.14)显著减少(P＜0.05);各实验组远端结肠HO-2表达无差异.正常对照组与DM未干预组近、远端结肠HO-1的表达无差异(Western blot示HO-1/α-tubulin:近端结肠0.22±0.02 vs 0.22±0.03;远端结肠0.23±0.03 vs 0.23±0.03,P＞0.05);DM Hemin组结肠HO-1的表达(近端结肠0.66±0.09;远端结肠0.47±0.07)较前两组显著增多(P＜0.05);DM ZnPP组结肠HO-1基本无表达.DM Hemin组胃肠推进指数(54.4%±2.9% vs 63.0%±1.2%,P＜0.05)、结肠平滑肌条自发收缩频率、波幅和对Ach的反应性较DM未干预组显著下降(P＜0.05),而DM ZnPP组胃肠推进指数(72.5%±2.6% vs 63.0%±1.2%,P＜0.05)、结肠平滑肌条自发收缩频率、波幅和对Ach的反应性较DM未干预组明显改善(P＜0.05).结论:HO干预(诱导或阻断),对DM大鼠体质量、血糖无影响.诱导HO-1使DM大鼠慢传输型结肠动力障碍加重,而阻断HO-1可能改善DM大鼠慢传输型结肠动力障碍.     

慢传输运动小鼠结肠组织中Cajal间质细胞的改变

背景：慢传输型便秘的发病机制尚不清楚。近年Cajal间质细胞（interstitial cells of Cajal，ICC）对胃肠平滑肌的起搏作用和介导神经递质的作用已被人们所认识，且在一些胃肠动力障碍性疾病中存在ICC数量和结构的异常改变。目的：探讨ICC在慢传输运动小鼠结肠组织中的改变。方法：经吗啡诱导建立结肠慢传输运动小鼠模型，采用免疫组化法观察各组小鼠结肠组织ICC的表达和分布；采用Western blot蛋白印迹试验和逆转录聚合酶链反应（RT-PCR）分析各组小鼠结肠组织c-Kit蛋白和c-kit mRNA的表达。结果：①45天后两实验组小鼠近端结肠组织免疫组化c—kit阳性细胞较对照组显著减少（P〈0．01），实验组Ⅱ较实验组Ⅰc-kit阳性细胞减少更明显（P〈0．01）；60天后停吗啡组的c-kit阳性细胞较纳洛酮阻断组和对照组显著减少（P〈0．01）。小鼠远端结肠组织c—kit阳性细胞在所有组别之间无显著差异。②45天后两实验组小鼠近端结肠组织c-Kit蛋白和c-kit mRNA的表达较对照组均显著减少（P均〈0．01）；60天后停吗啡组近端结肠组织c-Kit蛋白和c-kit mRNA的表达仍较纳洛酮阻断组和对照组显著减少（P〈0．05和P〈0．01）。结论：吗啡诱导的慢传输运动小鼠近端结肠组织中ICC数量下降，c—Kit蛋白和c-kit mRNA的表达明显减少，提示近端结肠ICC减少可能是结肠慢传输运动的原因之一；停用吗啡未能逆转ICC的变化，结肠慢传输运动也无改善。纳洛酮阻断后．ICC的变化基本恢复，结肠动力改善，纳洛酮可能阻止和恢复吗啡诱导的ICC数量的变化。     

针刺对结肠吻合术后Cajal间质细胞修复与再生的影响

目的:探讨针刺促进术后肠道动力恢复的机制.方法:30只SD大鼠随机分为空白组、模型组(行结肠吻合术)、针刺组.针刺组予每日针刺双侧足三针(足三里、三阴交、太冲),连续3d.观察大鼠排便情况,测量小肠推进率,观察结肠组织Cajal间质细胞(interstitial cells of Cajal,ICC)超微结构和胆碱能神经-ICC-平滑肌细胞网络结构.结果:针刺组术后首次排便时间较模型组提前,小肠推进率提高(2.00d±0.47d vs 2.50d±0.53d,66.30%±4.21% vs 46.33%±5.56%,P<0.05).与空白组比较,模型组ICC超微结构损伤明显,胆碱能神经-ICC-平滑肌细胞网络结构紊乱,ICC和小泡乙酰胆碱转移体(VAChT)阳性神经纤维数量明显减少(18.67±6.11 vs 32.33±5.51,18.67±3.79 vs 20.67±3.21,P<0.05)荧光强度减弱(35.00±9.54 vs 58.67±10.21,20.33±5.13 vs 34.67±6.81,P<0.05).而针刺组ICC超微结构损伤较模型组轻,网络样结构维持,ICC和VAChT阳性神经纤维的...     

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.     

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。     

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。     

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.     

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.     

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