胆固醇、胆固醇酯、胆碱酯酶在重症肝炎患者中的水平变化

目的：探讨胆固醇、胆固醇酯、胆碱酯酶的水平变化在重症肝炎患者病情变化中的意义。方法：选取2007年4月～2009年2月于我院治疗的53例重症肝炎患者为研究对象,将其设为A组,于治疗前后检测其胆固醇、胆固醇酯、胆碱酯酶水平,同时选取同期的50例健康人为对照组（B组）,检测其胆固醇、胆固醇酯、胆碱酯酶水平,后对两组胆固醇、胆固醇酯、胆碱酯酶水平进行比较分析。结果：经比较分析发现,A组治疗前胆固醇、胆固醇酯、胆碱酯酶水平与B组比较。差异有高度统计学意义（P〈0．01）;而治疗后两组比较,差异有统计学意义或差异无统计学意义（P〈0．05或P〉0．05）。结论：通过比较发现,重症肝炎患者的胆固醇、胆固醇酯、胆碱酯酶水平与其病情有着重要的关系,其水平变化可为疾病的治疗提供依据,值得临床进一步探讨。     

Characterization of muscle cholinesterases from two demersal flatfish collected near a municipal wastewater outfall in Southern California

Two cholinesterases (ChE) present in vertebrates, acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) are distributed in tissues in species-specific patterns. English sole (Pleuronectes vetulus, ES) and Hornyhead turbot (Pleuronichthys verticalis, HT) muscle ChE activities were measured in fish from a location near a municipal wastewater outfall and a far-field reference site off the coast of Southern California. ES muscle ChE correlated with total fish length (r=-0.3271) in fish from two sites. No significant differences were observed between gender or sampling sites. Substrate preference assays showed that both ChEs were found in muscle with BChE representing about 30% of the total ChE activity. Data resulting from the use of selective inhibitors suggested the presence of an atypical BChE. Higher sensitivity to pesticide inhibition was observed in ChEs from smaller fish. In HT muscle, ChE activities presented significant differences between males and females, but no correlation was found with total length. No significant differences were observed between sampling sites. Both ChEs were also present with BChE activity constituting 90% of the total ChE activity. Selective inhibitor results indicated the presence of an atypical ChE. Male ChE was more sensitive to pesticide inhibition. These data indicate that species, size, and gender dependent differences in ChE may contribute to differences in susceptibility to ChE-inhibiting toxicants encountered in the marine environment.     

Serial cholinesterase estimation in carbamate poisoning

Poisoning is one of the most important causes of morbidity and mortality in developing countries like India. Anticholinesterase compounds like organophosphates (OP) and carbamates account for the majority of these poisoning cases because of their easy availability and agricultural use. Carbamates are as popular as OPs as insecticides that often go undiagnosed. A fatal case of carbofuran poisoning is presented where serial cholinesterase estimation played a major role in the diagnosis of the same. The pertinent medical literature on carbofuran poisoning is reviewed. The establishment of poison information center in each state is needed for proper diagnosis and management of poisoning cases.     

急性呼吸窘迫综合征患儿血清胆碱酯酶、前白蛋白变化及预后的关系

目的了解急性呼吸窘迫综合征（ARDS）患儿急性期血清胆碱酯酶（CHE）、前白蛋白（PA）变化特点及临床意义,探讨CHE及PA变化及对预后的影响。方法51例的ARDS患儿分为未愈,死亡组（16例）与治愈／存活组（35例）,设同龄普通肺炎对照组患儿30例,全部于入组当天及患ARDS最重时分别检测血清CHE、血气分析、肝功能其他各项指标,41例同时检测血清PA。结果未愈,死亡组ARDS患儿于入组时及最重时血清CHE及PA均显著低于治愈／存活组（人组时均P〈0．05,最重时均P〈0．01）,氧合指数（PaOJFiO：）亦显著较低（均P〈0．05）。与正常儿童比较,两组的血清CHE、PA以及氧合指数均显著较低（均P〈0．01）。结论ARDS患儿急性期存在不同程度的血清CHE、PA及氧合指数降低,血清CHE、PA及氧合指数在一定程度上体现ARDS患儿病情的危重程度,对判断ARDS患儿预后有参考价值。     

老年重症社区获得性肺炎患者血清胆碱酯酶的变化及意义

目的 探讨血清胆碱酯酶(CHE)活性在老年重症社区获得性肺炎患者中的变化及临床意义.方法 检测重症肺炎组、普通肺炎组和健康对照组血清CHE活性, 将他们按性别分为男女两组,再分别比较男性、女性组中重症肺炎组、普通肺炎组和健康对照组血清CHE活性.结果 男性组血清CHE活性:重症肺炎组<普通肺炎组<健康对照组(P<0.01);女性组血清CHE活性:重症肺炎组<普通肺炎组<健康对照组(P<0.01).结论 老年重症社区获得性肺炎患者血清胆碱酯酶活性降低,降低程度与肺部炎症的严重程度密切相关.     

Is rivastigmine safe as pretreatment against nerve agents poisoning? A pharmacological,physiological and cognitive assessment in healthy young adult volunteers

Rivastigmine, a reversible cholinesterase inhibitor, approved as a remedy in Alzheimer's disease, was suggested as pretreatment against nerve agents poisoning. We evaluated the pharmacokinetic, pharmacodynamic, physiologic, cognitive and emotional effects of repeated rivastigmine in young healthy male adults, in a double blind, placebo controlled crossover trial. Three groups completed 3 treatment periods: 0, 1.5 and 3 mg twice a day, for a total of 5 intakes. Parameters monitored were: vital signs, ECG, laboratory tests, sialometry, visual accommodation, inspiratory peak flow, and cognitive function tests. Adverse reactions were mild. Peak blood levels and peak cholinesterase inhibition increased with repeated intakes, and high variability and non-linear pharmacokinetics were demonstrated. In addition, two cognitive functions were affected (perceptual speed and dynamic tracking). The complicated pharmacological profile and the high inter-personal variability limit the potential use of rivastigmine as pretreatment for war fighters and first responders.     

硫胺素在体和离体对胆碱酯酶活性的影响

本实验采用Ellman’s法检测胆碱酯酶(ChE)活性。硫胺素(VB_1)在试管内对小白鼠全血ChE的抑制曲线呈S型。其IC_(50)为1.95±0.14mM。DDVP的ChE抑制曲线形状同VB_1相似,但所需浓度很低。DDVP和VB_1对ChE的共同作用好似功能性交互作用。PAM-Ⅰ不能复活VB_1所抑制的ChE,同样浓度却能部分复活DDVP所抑制的ChE。分析VB_1对ChE的抑制可能属变构抑制。体内实验证明,给小鼠肌注50mg/kg,甚至200mg/kg的VB_1,并不抑制ChE。故推论VB_1配合PAM-Ⅰ解救DDVP急性中毒,有利无害。     

Ultrastructural localization of cholinesterase uring chondrogenesis and myogenesis in the chick limb bud

Summary Cholinesterase (ChE) is transiently expressed in undifferentiated embryonic cells. In the chick limb bud ChE-activity was found in the apical ectodermal ridge and in the subridge mesenchyme. The reaction was localized in the perinuclear cisterna, in an extensive network of narrow profiles of endoplasmic reticulum (ER), and in the Golgi complexThe chondroblasts emerging from the subridge mesenenyme, also showed strong ChE-activity. During differentiation the enzyme first disappeared from the Golgi zone. Then, the narrow ChE-positive ER was successively replaced by ChE-negative extended rough ER characteristic for the differentiated chondrocyte.The myoblasts showed weak ChE-activity with the same ultrastructural localization as in other mesenchymal cells. After fusion the myotubes exhibited strong ChE-activity in the perinuclear cisterna and the developing sarcoplasmic reticulum. In later stages of myogenesis the myoblasts were closely attached to the myotubes and had lost their ChE-activity.During mitosis of ChE-positive cells, ChE-activity was retained in fragments of perinuclear cisterna and ER. In ChE-active mesenchymal cells and chondroblasts we observed specialized contact zones between ER and plasma membrane. ChE-active cisternae of ER run parallel to the plasma membrane with a gap of approximately 10–15 nm. We discuss a possible function of a cholinergic system during morphogenesis.     

Accidental exposure to sarin: vision effects

Two men were accidentally exposed to vapors of sarin, a cholinesterase inhibitor and extremely toxic nerve gas. Diagnosis was confirmed by depressed cholinesterase activity, and fixed extremely miotic pupils. No other signs or symptoms developed and neither man required treatment. Recovery to normal cholinesterase activity was gradual over a 90-day period. Pupillary reflexes were not detectable until 11 days after exposure; the miotic pupils dilated slowly over a 30–45 day-period. Eye pain and blurred vision did not occur; visual acuity and amplitude of accommodation were improved for several weeks. Other functions not affected significantly were intraocular pressure, visual fields, color vision, heterophorias, and vergences.